Fetal Magnetic Resonance Imaging (MRI) Enhances the Diagnosis of Congenital Body Anomalies
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Read the article on jpedsurg.org ↗Article · Oct 2021 · 1 min read
In brief
In brief
Study of 54 cases demonstrates fetal MRI changed clinical management in 59% of fetuses with known body anomalies and detected additional findings in 7% of cases with cardiac/CNS concerns, including missed oesophageal atresia and anorectal malformations. MRI provides superior characterization of fetal anomalies compared to ultrasound alone, with implications for both antenatal and postnatal care planning.
Written by the GCMD Library team from the article.
AIMS
: We sought to assess variability and concordance between fetal MRI and ultrasound (USS) in the evaluation of fetal body abnormalities.
METHODS
: All fetal body anomalies reported on F-MRI within the iFIND database (www.ifindproject.com) were included. Differences in findings regarding anomalies on contemporaneous USS were explored. Three clinical specialists evaluated each case independently, and the anomaly severity was graded: as "insignificant" to "lethal". The value of MRI in alteration of either antenatal or postnatal care was established.
RESULTS
: Fifty-four cases were identified consisting of 5 healthy controls, 37 with USS-identified body anomalies, and 12 with known CNS or cardiac anomalies. In fetuses with a known body anomaly, information on the MRI was relevant to change the clinical course in 59% of cases. There was also an incidental detection rate of 7% in fetuses with known cardiac or CNS anomalies, or 1.5% of normal control, although these were rarely clinically relevant.
Importantly, fetuses undergoing MRI for cardiac concerns did have major anomalies that were missed (one case of oesophageal atresia and two cases of ARM).
CONCLUSIONS
: In cases where fetal anomalies are suspected, F-MRI is a valuable means of further characterising anomalies and may detect additional anomalies in fetuses with recognised cardiac or CNS anomalies. In fetuses with a recognised body anomaly, over half of those scanned by MRI had information available which changed clinical management. Importantly there were also incidental findings in healthy control fetuses, so the management of these needs to be recognised in fetal MRI research.