The Contribution of MRI after Fetal Anomalies Have Been Diagnosed by Ultrasound: Correlation with Postnatal Outcomes

Abstract

Objective: The aim of this study was to investigate the additional value of fetal magnetic resonance imaging (MRI) in the assessment and management of fetuses with abnormal findings on ultrasound. Methods: A total of 257 patients who had fetal MRI following the ultrasound diagnosis of a fetal anomaly, or were at high risk, were included. The patients were grouped by referral category for fetal MRI. Fetal MRI was compared to ultrasound in the detection of anomalies, i.e. whether additional findings were identified and if this changed diagnosis, prognosis and management during pregnancy. Results: Ultrasound findings were confirmed on fetal MRI in 89% of the cases. Additional findings were seen with MRI in 28% of all patients. The diagnosis changed in 21% and the prognosis in 19% of the cases. Perinatal management changed in 8%. The antenatal findings were confirmed in all cases that had a postmortem examination following termination of pregnancy. In all the pregnancies that continued to delivery and for which the postnatal outcome is known, the findings correlated in 97% of the cases. Conclusion: Fetal MRI provided additional detection of fetal anomalies, leading to a change in diagnosis and prognosis in 19% of the cases. Neonatal and postmortem findings mostly confirmed the fetal MRI diagnosis, suggesting it to be a useful tool for clinical decision making in perinatal management.

Diagnostic accuracy of ultrasonography and magnetic resonance imaging for the detection of fetal anomalies: a blinded case-control study

“…Widespread acceptance into clinical practice occurred in the late 1990s after the introduction of fast MRI sequences, which obviated the need for maternal sedation to reduce fetal movement. Since then, several investigators have reported on the accuracy of fetal MRI compared with that of ultrasonography (US) in the diagnosis of congenital anomalies. More recently, a systematic review summarized the results of previous studies related to the prenatal diagnosis of central nervous system (CNS) anomalies.…”

A retrospective cohort analysis on the contribution of fetal magnetic resonance imaging to the diagnosis and management of sonographically detected fetal abnormalities

“…İşte bu prenatal sonografik taramalarda bir anormallik saptandığında ultrasonografiye yardımcı veya ultrasonografik bulguları tamamlayıcı bir görüntüleme modalitesine ihtiyaç doğmaktadır (1)(2)(3). Manyetik rezonans görüntüleme (MRG); gebelikte güvenli olması, yüksek görüntü çözünürlüğünün sağladığı tanısal başarısı ve görüntülerin arşivlenebilmesi gibi avantajları ile bu ihtiyaca cevap verebilen en önemli diagnostik modalitedir (1,2,4).…”

Short- and Long-Term Outcomes of Prenatally Diagnosed Dandy-Walker Malformation, Vermian Hypoplasia, and Blake Pouch Cyst

“…Abnormalities of the central nervous detected via fetal ultrasound often prompt a referral for a fetal magnetic resonance imaging (MRI) study, which can help clarify diagnosis. [1][2][3] Over the last 20 years, there has been greater recognition that Blake pouch cyst, vermian hypoplasia, and "classic Dandy-Walker malformation" exist along a continuum of abnormalities resulting from abnormal development of the posterior membranous area during fourth ventricular development 4,5 and are commonly referred as the Dandy-Walker continuum, Dandy-Walker spectrum, or Dandy-Walker complex. Outcome in these conditions is variable.…”