DOI: https://dx.doi.org/10.18203/2320-6012.ijrms20220281
Published: 2022-01-29

A study of fetal anomalies: contribution of ultrasonography and magnetic resonance imaging

Vineet Vij, Rahul Dev Chauhan, Amit Choubey

Abstract


Background: Ultrasonography (USG) remains the primary modality for fetal imaging. Magnetic resonance imaging (MRI) is a suitable adjunct to USG. MRI is currently not used as a primary screening tool for antenatal period; however, it provides a reproducible fetal anatomy and can be more informative when the diagnosis on antenatal USG is inconclusive. Aim of the study was to study the contribution of antenatal USG and MRI in diagnosing fetal anomalies at a zonal hospital.

Methods: This was a prospective cross-sectional study enrolling the pregnant women between 13 to 35 weeks of gestation. The 30 consecutive fetuses suspected to have fetal anomaly on USG, were subjected to MRI after obtaining informed consent. Final diagnosis was made either radiologically (including follow up) or by clinical examination or autopsy.

Results: In 30 cases, 31 anomalies were detected on USG. There were 14 anomalies pertaining to central nervous system (CNS), 05 anomalies of genitourinary tract (GUT), 04 anomalies of thorax, 03 anomalies of gastrointestinal tract (GIT) and, 05 anomalies involving other body parts of fetus. MRI could detect 28 anomalies. USG was able to characterize a case of dorsal meningo-myelocoele better than MRI. MRI was able to show the extent of other anomalies better than USG and provided additional information of horseshoe shape in 01 case of multi cystic dysplastic kidneys. MRI could not detect 03 cases of single umbilical artery.

Conclusions: USG is the primary modality for fetal imaging. MRI can be a used as an adjunct to USG for confirmation and better delineation of anomalies.

 


Keywords


Fetal anomalies, Ultrasound, MRI

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References


Kul S, Korkmaz HAA, Cansu A, Dinc S, Ahmetoglu A, Guven S et al. Contribution of MRI to ultrasound in the diagnosis of fetal anomalies. J Magn Reson Imaging. 2012;35(4):882-90.

Levine D, Feldman HA, Tannus JFK, Estroff JA, Magnino M, Robson CD et al. Frequency and Cause of Disagreements in Diagnoses for Fetuses Referred for Ventriculomegaly1. Radiology. 2008;247(2):516-27.

Levine D. Obstetric MRI. J Magn Reson Imaging. 2006;24(1):1-15.

Shellock FG, Crues JV. MR procedures: biologic effects, safety, and patient care. Radiology. 2004;232(3):635-52.

Frates MC, Kumar AJ, Benson CB, Ward VL, Tempany CM. Fetal Anomalies: Comparison of MR Imaging and US for Diagnosis. Radiology. 2004;232(2):398-404.

Campbell S. A Short History of Sonography in Obstetrics and Gynaecology. Facts Views Vis ObGyn. 2013;5(3):213-29.

Benson CB, Doubilet PM. The History of Imaging in Obstetrics. Radiology. 2014;273(2S):S92-110.

Amini H, Wikström J, Ahlström H, Axelsson O. Second trimester fetal magnetic resonance imaging improves diagnosis of non-central nervous system anomalies. Acta Obstet Gynecol Scand. 2011;90(4):380-89.

Santos XM, Papanna R, Johnson A, Cass DL, Olutoye OO, Moise KJ et al. The use of combined ultrasound and magnetic resonance imaging in the detection of fetal anomalies. Prenat Diagn. 2010;30(5):402-7.

Aaronson OS, Hernanz-Schulman M, Bruner JP, Reed GW, Tulipan NB. Myelomeningocele: prenatal evaluation--comparison between transabdominal US and MR imaging. Radiology. 2003;227(3):839-43.

Debus A, Hagelstein C, Kilian AK, Weiss C, Schonberg SO, Schaible T et al. Fetal lung volume in congenital diaphragmatic hernia: association of prenatal MR imaging findings with postnatal chronic lung disease. Radiology. 2013;266(3):887-95.

Spalluto LB, Woodfield CA, DeBenedectis CM, Lazarus E. MR imaging evaluation of abdominal pain during pregnancy: appendicitis and other nonobstetric causes. Radiogr Rev Publ Radiol Soc N Am Inc. 2012;32(2):317-34.

Rapp EJ, Naim F, Kadivar K, Davarpanah A, Cornfeld D. Integrating MR imaging into the clinical workup of pregnant patients suspected of having appendicitis is associated with a lower negative laparotomy rate: single-institution study. Radiology. 2013;267(1):137-44.

Sohn YS, Kim MJ, Kwon JY, Kim YH, Park YW. The Usefulness of Fetal MRI for Prenatal Diagnosis. Yonsei Med J. 2007;48(4):671-7.

Sharma A, Kapoor K, Singh K, Sharma A, Singh B, Huria A et al. Congential anomalies in North Western Indian population a fetal autopsy study. Eur J Anat. 2013;17(3):166-75.

Whitby E, Paley MN, Davies N, Sprigg A, Griffiths PD. Ultrafast magnetic resonance imaging of central nervous system abnormalities in utero in the second and third trimester of pregnancy: comparison with ultrasound. BJOG Int J Obstet Gynaecol. 2001;108(5):519-26.

Hosny IA, Elghawabi HS. Ultrafast MRI of the fetus: an increasingly important tool in prenatal diagnosis of congenital anomalies. Magn Reson Imaging. 2010;28(10):1431-9.

Hamisa M, Dabees N, Ataalla WM, Ziada DH. Magnetic resonance imaging versus Ultrasound examination in detection of prenatal fetal brain anomalies. Egypt J Radiol Nucl Med. 2013;44(3):665-72.

Levine D, Barnes PD, Madsen JR, Li W, Edelman RR. Fetal central nervous system anomalies: MR imaging augments sonographic diagnosis. Radiology. 1997;204(3):635-42.

Cassart M, Massez A, Metens T, Rypens F, Lambot MA, Hall M et al. Complementary Role of MRI After Sonography in Assessing Bilateral Urinary Tract Anomalies in the Fetus. Am J Roentgenol. 2004;182(3):689-95.

Behairy N, Adel L, Hanoun N, Raof M, Ali M. Diagnostic value of fetal MRI in evaluating fetal urinary anomalies. Egypt J Radiol Nucl Med. 2015;164.