Susceptibility‐weighted imaging to evaluate normal and abnormal vertebrae in fetuses: A preliminary study

Abstract

Objective: To evaluate the performance of susceptibility-weighted imaging (SWI) in visualizing normal and abnormal fetal vertebrae in vivo and in utero.Methods: Ninety-seven women with normal fetal vertebrae and 127 women suspected fetal vertebral anomalies on ultrasound were included in our study. SWI, true fast imaging with steady state precession (TrueFISP), and half-Fourier acquisition single-shot turbo spin-echo (HASTE) of the fetal spine were performed on 1.5-T magnetic resonance imaging. The image quality and diagnostic performance between HASTE/TrueFISP and SWI were compared. Pearson correlations to correlate the L1 centrum ossification center (COC) measurements with gestational age (GA) were performed. Results:The visibility of the fetal vertebral structures on the SWI images (3.58 � 0.69) was significantly greater than those on the HASTE (1.98 � 0.51, p < 0.001) and TrueFISP (2.63 � 0.52, p < 0.001). The diagnostic accuracy of SWI (89.0%) was superior to HASTE/TrueFISP (48.0%) (p < 0.001) and the area under the curve for SWI was 0.909 (p < 0.001). The height, transverse, sagittal diameter, and area of L1 COC were linearly correlated with GA (all p < 0.001). Conclusion:SWI proved to be a reliable method for depicting fetal vertebral structure and growth, which can significantly improve the diagnostic performance of vertebral anomalies in fetuses. Key points What's already know about this topic?� Conventional magnetic resonance imaging (MRI) sequences are not ideal for visualizing fetal osseous structures, especially spinal bony structures, leaving fetal vertebral development and related anomalies largely unexplored.� Susceptibility-weighted imaging (SWI) is a method to improve the visibility of various susceptibility sources and has recently been modified for fetal spine imaging. What' does this study added?� SWI was better than conventional MRI sequences in depicting fetal vertebral structures, and could determine the normal evolution of the fetal vertebrae across different age groups in vivo and in utero.� SWI could achieve the best diagnostic performance for fetal vertebral anomalies in fetal spine imaging.