Magnetic Resonance Imaging in the Second Trimester As a Complement to Ultrasound for Diagnosis of Fetal Anomalies

Overview

Journal Acta Radiol Open

Specialty Radiology

Date 2024 May 13

PMID 38737558

Authors

Frida Cederlund

Ove Axelsson

Sara Desmond

Hashem Amini

Johan Wikstrom

Affiliations

Soon will be listed here.

Abstract

Background: Fetal ultrasound has limitations, especially if the patient is obese or in cases with oligohydramnios. Magnetic resonance imaging (MRI) can then be used as a complement, but only few studies have focused on examinations in the second trimester.

Purpose: To validate MRI as a complement to diagnose fetal anomalies in the second trimester.

Material And Methods: This retrospective study retrieved data from January 2008 to July 2012 from the Fetal Medicine Unit and Department of Radiology at Uppsala University Hospital. Ultrasound and MRI findings were reviewed in 121 fetuses in relation to the final diagnosis, including postpartum follow-up and autopsy results.

Results: Of the 121 fetuses, 51 (42%) had a CNS anomaly and 70 (58%) a non-CNS anomaly diagnosed or suspected. MRI provided additional information in 21% of all cases without changing the management and revealed information that changed the management of the pregnancy in 13%. When a CNS anomaly was detected or suspected, the MRI provided additional information in 22% and changed the management in 10%. The corresponding figures for non-CNS cases were 21% and 16%, respectively. The proportion of cases with additional information that changed the management was especially high in patients with a BMI >30 kg/m (25%) and in patients with oligohydramnios (38%). In five cases in category III, false-positive ultrasound findings were identified.

Conclusions: MRI in the second trimester complements ultrasound and improves diagnosis of fetal CNS- and non-CNS anomalies especially when oligohydramnios or maternal obesity is present.

References

Pugash D, Brugger P, Bettelheim D, Prayer D . Prenatal ultrasound and fetal MRI: the comparative value of each modality in prenatal diagnosis. Eur J Radiol. 2008; 68(2):214-26. DOI: 10.1016/j.ejrad.2008.06.031. View

Style C, Mehollin-Ray A, Verla M, Lau P, Cruz S, Espinoza J . Timing of Prenatal Magnetic Resonance Imaging in the Assessment of Congenital Diaphragmatic Hernia. Fetal Diagn Ther. 2019; 47(3):205-213. DOI: 10.1159/000501556. View

Fadda G, Capobianco G, Balata A, Litta P, Ambrosini G, DAntona D . Routine second trimester ultrasound screening for prenatal detection of fetal malformations in Sassari University Hospital, Italy: 23 years of experience in 42,256 pregnancies. Eur J Obstet Gynecol Reprod Biol. 2009; 144(2):110-4. DOI: 10.1016/j.ejogrb.2009.02.045. View

Millischer A, Sonigo P, Ville Y, Brunelle F, Boddaert N, Salomon L . Standardized fetal anatomical examination using magnetic resonance imaging: a feasibility study. Ultrasound Obstet Gynecol. 2013; 42(5):553-9. DOI: 10.1002/uog.12415. View

Griffiths P, Bradburn M, Campbell M, Cooper C, Graham R, Jarvis D . Use of MRI in the diagnosis of fetal brain abnormalities in utero (MERIDIAN): a multicentre, prospective cohort study. Lancet. 2016; 389(10068):538-546. DOI: 10.1016/S0140-6736(16)31723-8. View

Paladini D, Quarantelli M, Sglavo G, Pastore G, Cavallaro A, DArmiento M . Accuracy of neurosonography and MRI in clinical management of fetuses referred with central nervous system abnormalities. Ultrasound Obstet Gynecol. 2013; 44(2):188-96. DOI: 10.1002/uog.13243. View

Rossi A, Prefumo F . Additional value of fetal magnetic resonance imaging in the prenatal diagnosis of central nervous system anomalies: a systematic review of the literature. Ultrasound Obstet Gynecol. 2014; 44(4):388-93. DOI: 10.1002/uog.13429. View

Kul S, Ata Korkmaz H, Cansu A, Dinc H, Ahmetoglu A, Guven S . Contribution of MRI to ultrasound in the diagnosis of fetal anomalies. J Magn Reson Imaging. 2011; 35(4):882-90. DOI: 10.1002/jmri.23502. View

Verburg B, Fink A, Reidy K, Palma-Dias R . The Contribution of MRI after Fetal Anomalies Have Been Diagnosed by Ultrasound: Correlation with Postnatal Outcomes. Fetal Diagn Ther. 2015; 38(3):186-94. DOI: 10.1159/000380821. View

10.

Whitby E, Paley M, Sprigg A, Rutter S, Davies N, Wilkinson I . Comparison of ultrasound and magnetic resonance imaging in 100 singleton pregnancies with suspected brain abnormalities. BJOG. 2004; 111(8):784-92. DOI: 10.1111/j.1471-0528.2004.00149.x. View

11.

Goncalves L, Lee W, Mody S, Shetty A, Sangi-Haghpeykar H, Romero R . Diagnostic accuracy of ultrasonography and magnetic resonance imaging for the detection of fetal anomalies: a blinded case-control study. Ultrasound Obstet Gynecol. 2015; 48(2):185-92. PMC: 5987216. DOI: 10.1002/uog.15774. View

12.

Amini H, Wikstrom J, Ahlstrom H, Axelsson O . Second trimester fetal magnetic resonance imaging improves diagnosis of non-central nervous system anomalies. Acta Obstet Gynecol Scand. 2011; 90(4):380-9. DOI: 10.1111/j.1600-0412.2011.01071.x. View

13.

Recio Rodriguez M, Andreu-Vazquez C, Thuissard-Vasallo I, Cano Alonso R, Bermejo Lopez C, Tamarit Degenhardt I . Real-Life Diagnostic Accuracy of MRI in Prenatal Diagnosis. Radiol Res Pract. 2020; 2020:4085349. PMC: 7542514. DOI: 10.1155/2020/4085349. View

14.

Prayer D, Malinger G, Brugger P, Cassady C, De Catte L, De Keersmaecker B . ISUOG Practice Guidelines: performance of fetal magnetic resonance imaging. Ultrasound Obstet Gynecol. 2017; 49(5):671-680. DOI: 10.1002/uog.17412. View

15.

Amini H, Axelsson O, Raiend M, Wikstrom J . The clinical impact of fetal magnetic resonance imaging on management of CNS anomalies in the second trimester of pregnancy. Acta Obstet Gynecol Scand. 2010; 89(12):1571-81. DOI: 10.3109/00016349.2010.526184. View

16.

Amini H, Antonsson P, Papadogiannakis N, Ericson K, Pilo C, Eriksson L . Comparison of ultrasound and autopsy findings in pregnancies terminated due to fetal anomalies. Acta Obstet Gynecol Scand. 2006; 85(10):1208-16. DOI: 10.1080/00016340600880886. View