Fetal MRI in the evaluation of fetuses referred for sonographically suspected neural tube defects (NTDs): impact on diagnosis and management decision

Introduction We hypothesized that magnetic resonance imaging (MRI) can assess fetuses with sonographically (ultrasonography (US))-suspected neural tube defects (NTD) that might influence their diagnoses and management decision. Methods Institutional review board approval and informed consents were o...

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Bibliographic Details
Published in:Neuroradiology 2009-11, Vol.51 (11), p.761-772
Main Authors: Saleem, Sahar N., Said, Ahmed-Hesham, Abdel-Raouf, Maged, El-Kattan, Eman A., Zaki, Maha Saad, Madkour, Noha, Shokry, Mostafa
Format: Article
Language:English
Subjects:
Anencephaly - diagnosis
Anencephaly - diagnostic imaging
Anencephaly - pathology
Biological and medical sciences
Cysts - diagnosis
Cysts - pathology
Cysts - ultrastructure
Diagnosis, Differential
Fetus - pathology
Fetuses
Fundamental and applied biological sciences. Psychology
Humans
Imaging
Investigative techniques, diagnostic techniques (general aspects)
Magnetic Resonance Imaging - methods
Medical diagnosis
Medical sciences
Medicine
Medicine & Public Health
Meningocele - diagnosis
Meningocele - diagnostic imaging
Meningocele - pathology
Meningomyelocele - diagnosis
Meningomyelocele - diagnostic imaging
Meningomyelocele - pathology
Nervous system
Neural Tube Defects - diagnosis
Neural Tube Defects - diagnostic imaging
Neural Tube Defects - pathology
Neurological disorders
Neurology
Neuroradiology
Neurosciences
Neurosurgery
NMR
Nuclear magnetic resonance
Paediatric Neuroradiology
Perception
Prenatal Diagnosis - methods
Psychology. Psychoanalysis. Psychiatry
Psychology. Psychophysiology
Radiodiagnosis. Nmr imagery. Nmr spectrometry
Radiology
Ultrasonography, Prenatal
Vision
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Summary:Introduction We hypothesized that magnetic resonance imaging (MRI) can assess fetuses with sonographically (ultrasonography (US))-suspected neural tube defects (NTD) that might influence their diagnoses and management decision. Methods Institutional review board approval and informed consents were obtained to perform MRI for 19 fetuses referred with US-suspected NTD. Prenatal imaging findings were correlated with management decision, postnatal clinical, postnatal imaging, and pathology. Results Prenatal MRI correctly ruled out US diagnosis of cephalocele in a fetus. In the other 18 fetuses, MRI detected detailed topography and contents of NTD sacs in five, added central nervous system (CNS) abnormalities that were not apparent on US in three, and confirmed non-CNS findings in three fetuses. MRI changed diagnosis of 3/19 fetuses (15.8%), caused minor change in diagnosis of 5/19 (26.3%), and did not influence US diagnosis of 11/19 fetuses (57.9%). MRI findings changed/modified management decision in 21% of the fetuses. Conclusion Fetal MRI is an important adjunct to US in assessing NTD. It can identify topography and contents of sacs, add CNS and non-CNS findings, and influence management decision.
ISSN:0028-3940
1432-1920
DOI:10.1007/s00234-009-0549-0