Marco Di Maurizio MD, Presenter: Nothing to Disclose

Lucia Manganaro MD, Abstract Co-Author: Nothing to Disclose

Porzia Totaro MD, Abstract Co-Author: Nothing to Disclose

antonella francioso, Abstract Co-Author: Nothing to Disclose

Fabio Coratella, Abstract Co-Author: Nothing to Disclose

Daniela Irimia MD, Abstract Co-Author: Nothing to Disclose

Laura Ballesio MD, Abstract Co-Author: Nothing to Disclose

To report our experience in the assessment of fetal anatomical structures and major fetal pathologies with magnetic resonance imaging (MRI).

We retrospectively studied 239 pregnant women between the 22nd and 38th week of gestation, who were referred to our centre between February 2002 and March 2008 for an obstetric MRI examination. In most cases (210/239), the indication for MRI was the need to further assess fetal anomalies previously visualised at obstetric ultrasound (US) examination but not fully characterised. MRI protocol included: T2-weighted single-shot fast spin-echo sequences for all fetuses and, in selected cases, gradient echo with steady-state free precession (SSFP) sequences, T1-weighted spoiled gradient echo fast low-angle shot (FLASH) sequences with and without fat saturation, and T2 thick-slab sequences with multiplanar technique. In 120 cases, we performed diffusion-weighted sequences with apparent diffusion coefficient (ACD) maps on the brain, the kidneys and the lungs.

In 29/239 cases with previous negative US findings MRI confirmed the US diagnosis. In the remaining 210 cases with positive US examination, the comparison between US and MRI findings revealed a substantial agreement between the two techniques in 66% of cases (138/210): in 47 out of 138 cases MRI was also able to identify and provide a greater detail for the anomalies identified by US and in 15 out of 138 cases adjunctive fetal anomalies missed at US were identified with MRI. In 10% of cases (21/210) MRI proved instrumental in recognition of the pathology, providing a precise diagnosis that was different to the one suggested by US while in 24% of cases (51/210) MRI examination was negative despite US findings.  

MRI with fast imaging has a crucial role in the recognition of the finest details of normal fetal anatomy. The technique, which is still complementary to obstetric US in the characterisation of suspected organ anomalies, contributes to pregnancy management and therapy planning pre- or postnatally, when required.

Fetal MRI gives a contribution in the prenatal diagnosis and pregnancy management when US provides indicative information that is not sufficiently conclusive for a therapeutic decision.   

Di Maurizio, M, Manganaro, L, Totaro, P, francioso, a, Coratella, F, Irimia, D, Ballesio, L, Study of Fetal Anatomical Structures and Pathology: Magnetic Resonance Imaging versus Ultrasonography.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6020728.html