Fetal magnetic resonance imaging (MRI) enhances the diagnosis of congenital body anomalies

Joseph R. Davidson; Kirsty Brennan; Jacqueline Matthew; Zoe Hesketh; David Lloyd; Alexia Egloff; Iain E. Yardley; Mary A. Rutherford; Lisa Story

doi:10.1016/j.jpedsurg.2021.10.033

Fetal magnetic resonance imaging (MRI) enhances the diagnosis of congenital body anomalies

Joseph R. Davidson^*, Kirsty Brennan, Jacqueline Matthew, Zoe Hesketh, David Lloyd, Alexia Egloff, Iain E. Yardley, Mary A. Rutherford, Lisa Story

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

4 Citations (Scopus)

Abstract

Aims: We sought to assess variability and concordance between fetal MRI and ultrasound (USS) in the evaluation of fetal body abnormalities. Methods: All fetal body anomalies reported on F-MRI within the iFIND database (http://www.ifindproject.com) were included. Differences in findings regarding anomalies on contemporaneous USS were explored. Three clinical specialists evaluated each case independently, and the anomaly severity was graded: as “insignificant” to “lethal”. The value of MRI in alteration of either antenatal or postnatal care was established. Results: Fifty-four cases were identified consisting of 5 healthy controls, 37 with USS-identified body anomalies, and 12 with known CNS or cardiac anomalies. In fetuses with a known body anomaly, information on the MRI was relevant to change the clinical course in 59% of cases. There was also an incidental detection rate of 7% in fetuses with known cardiac or CNS anomalies, or 1.5% of normal control, although these were rarely clinically relevant. Importantly, fetuses undergoing MRI for cardiac concerns did have major anomalies that were missed (one case of oesophageal atresia and two cases of ARM). Conclusions: In cases where fetal anomalies are suspected, F-MRI is a valuable means of further characterizing anomalies and may detect additional anomalies in fetuses with recognized cardiac or CNS anomalies. In fetuses with a recognized body anomaly, more than half of those scanned by MRI had information available which changed clinical management. Importantly there were also incidental findings in healthy control fetuses, so the management of these needs to be recognized in fetal MRI research. Level of evidence: II, Prospective cohort study.

Original language	English
Pages (from-to)	239-244
Number of pages	6
Journal	Journal of Pediatric Surgery
Volume	57
Issue number	2
Early online date	2 Feb 2022
DOIs	https://doi.org/10.1016/j.jpedsurg.2021.10.033
Publication status	Published - Feb 2022

Keywords

Antenatal counselling
Antenatal ultrasound
Fetal MRI
Prenatal diagnosis

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10.1016/j.jpedsurg.2021.10.033

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title = "Fetal magnetic resonance imaging (MRI) enhances the diagnosis of congenital body anomalies",

abstract = "Aims: We sought to assess variability and concordance between fetal MRI and ultrasound (USS) in the evaluation of fetal body abnormalities. Methods: All fetal body anomalies reported on F-MRI within the iFIND database (http://www.ifindproject.com) were included. Differences in findings regarding anomalies on contemporaneous USS were explored. Three clinical specialists evaluated each case independently, and the anomaly severity was graded: as “insignificant” to “lethal”. The value of MRI in alteration of either antenatal or postnatal care was established. Results: Fifty-four cases were identified consisting of 5 healthy controls, 37 with USS-identified body anomalies, and 12 with known CNS or cardiac anomalies. In fetuses with a known body anomaly, information on the MRI was relevant to change the clinical course in 59% of cases. There was also an incidental detection rate of 7% in fetuses with known cardiac or CNS anomalies, or 1.5% of normal control, although these were rarely clinically relevant. Importantly, fetuses undergoing MRI for cardiac concerns did have major anomalies that were missed (one case of oesophageal atresia and two cases of ARM). Conclusions: In cases where fetal anomalies are suspected, F-MRI is a valuable means of further characterizing anomalies and may detect additional anomalies in fetuses with recognized cardiac or CNS anomalies. In fetuses with a recognized body anomaly, more than half of those scanned by MRI had information available which changed clinical management. Importantly there were also incidental findings in healthy control fetuses, so the management of these needs to be recognized in fetal MRI research. Level of evidence: II, Prospective cohort study.",

keywords = "Antenatal counselling, Antenatal ultrasound, Fetal MRI, Prenatal diagnosis",

author = "Davidson, {Joseph R.} and Kirsty Brennan and Jacqueline Matthew and Zoe Hesketh and David Lloyd and Alexia Egloff and Yardley, {Iain E.} and Rutherford, {Mary A.} and Lisa Story",

note = "Publisher Copyright: {\textcopyright} 2021 Elsevier Inc.",

year = "2022",

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doi = "10.1016/j.jpedsurg.2021.10.033",

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volume = "57",

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AU - Davidson, Joseph R.

AU - Brennan, Kirsty

AU - Matthew, Jacqueline

AU - Hesketh, Zoe

AU - Lloyd, David

AU - Egloff, Alexia

AU - Yardley, Iain E.

AU - Rutherford, Mary A.

AU - Story, Lisa

PY - 2022/2

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N2 - Aims: We sought to assess variability and concordance between fetal MRI and ultrasound (USS) in the evaluation of fetal body abnormalities. Methods: All fetal body anomalies reported on F-MRI within the iFIND database (http://www.ifindproject.com) were included. Differences in findings regarding anomalies on contemporaneous USS were explored. Three clinical specialists evaluated each case independently, and the anomaly severity was graded: as “insignificant” to “lethal”. The value of MRI in alteration of either antenatal or postnatal care was established. Results: Fifty-four cases were identified consisting of 5 healthy controls, 37 with USS-identified body anomalies, and 12 with known CNS or cardiac anomalies. In fetuses with a known body anomaly, information on the MRI was relevant to change the clinical course in 59% of cases. There was also an incidental detection rate of 7% in fetuses with known cardiac or CNS anomalies, or 1.5% of normal control, although these were rarely clinically relevant. Importantly, fetuses undergoing MRI for cardiac concerns did have major anomalies that were missed (one case of oesophageal atresia and two cases of ARM). Conclusions: In cases where fetal anomalies are suspected, F-MRI is a valuable means of further characterizing anomalies and may detect additional anomalies in fetuses with recognized cardiac or CNS anomalies. In fetuses with a recognized body anomaly, more than half of those scanned by MRI had information available which changed clinical management. Importantly there were also incidental findings in healthy control fetuses, so the management of these needs to be recognized in fetal MRI research. Level of evidence: II, Prospective cohort study.

AB - Aims: We sought to assess variability and concordance between fetal MRI and ultrasound (USS) in the evaluation of fetal body abnormalities. Methods: All fetal body anomalies reported on F-MRI within the iFIND database (http://www.ifindproject.com) were included. Differences in findings regarding anomalies on contemporaneous USS were explored. Three clinical specialists evaluated each case independently, and the anomaly severity was graded: as “insignificant” to “lethal”. The value of MRI in alteration of either antenatal or postnatal care was established. Results: Fifty-four cases were identified consisting of 5 healthy controls, 37 with USS-identified body anomalies, and 12 with known CNS or cardiac anomalies. In fetuses with a known body anomaly, information on the MRI was relevant to change the clinical course in 59% of cases. There was also an incidental detection rate of 7% in fetuses with known cardiac or CNS anomalies, or 1.5% of normal control, although these were rarely clinically relevant. Importantly, fetuses undergoing MRI for cardiac concerns did have major anomalies that were missed (one case of oesophageal atresia and two cases of ARM). Conclusions: In cases where fetal anomalies are suspected, F-MRI is a valuable means of further characterizing anomalies and may detect additional anomalies in fetuses with recognized cardiac or CNS anomalies. In fetuses with a recognized body anomaly, more than half of those scanned by MRI had information available which changed clinical management. Importantly there were also incidental findings in healthy control fetuses, so the management of these needs to be recognized in fetal MRI research. Level of evidence: II, Prospective cohort study.

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JO - Journal of Pediatric Surgery

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ER -

Fetal magnetic resonance imaging (MRI) enhances the diagnosis of congenital body anomalies

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Keywords

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