Sahar Saleem MD, Presenter: Nothing to Disclose

Maha S. Zaki MD, Abstract Co-Author: Nothing to Disclose

Samah Abul-Ghait MD, Abstract Co-Author: Nothing to Disclose

M. Shokry MD, Abstract Co-Author: Nothing to Disclose

To determine the value of fetal MRI as an adjunct to US in prenatal screening for suspected brain anomalies

The study included 80 pregnant women in whom US was suspicious of fetal brain anomaly and/or with history of previous pregnancies with brain malformations. All pregnancies underwent dedicated neurosonogram followed by comprehensive ultrafast MRI in 3 orthogonal planes. Fetal MRI and US findings were compared and correlated with clinical data to reach a management decision. Final diagnoses were confirmed by postnatal clinical examination in a period that ranged between 2-46 months, postnatal MRI or autopsy.

Fetal MRI detected 33 brain abnormalities in 18 fetuses and described 62 as normal. Fetal MRI diagnoses included: ventriculomegaly, Dandy Walker malformation, olivo-pontocerebellar hypoplasia, Chiari II malformation, schizencephaly, agenesis of corpus callosum, microcephaly, simplified gyration, cobblestone lissencephaly, Iniencephaly, Meckel-Gruber syndrome, Turner syndrome, Noonan syndrome, and non-classified malformations. In comparison with US, MRI confirmed US diagnoses in 33 cases, made clear diagnoses in 26 cases with equivocal US studies that improved the confidence level in management decisions, provided additional findings not detected by US that influenced counseling in 8 cases, and correctly changed US diagnoses and management in 11 cases. A subtle molar tooth sign in a case of Joubert syndrome and mild cerebral parenchymal signal abnormalities in a case of congenital muscular dystrophy were overlooked in prenatal imaging and were only diagnosed by postnatal MRI. Fetal MRI was particularly valuable in screening for abnormalities of cerebral cortical development, posterior fossa, and corpus callosum.

Fetal MRI provided a measure of confidence and additional information that confirmed or changed the prenatal US diagnoses of pregnancies high risk for brain anomalies.

Fetal MRI is a powerful screening tool for fetal brain anomalies.

Saleem, S, Zaki, M, Abul-Ghait, S, Shokry, M, Comparison of MRI and Ultrasonography in the Prenatal Screening of Brain Anomalies.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5001682.html