Prenatale diagnostiek van foetale afwijkingen; aanvulling met ultrasnelle MRI mogelijk bij onduidelijke echoscopische bevindingen

To determine the value of ultra-fast magnetic resonance imaging (MRI) in supplementing the prenatal diagnosis of congenital abnormalities by ultrasound.

Design

Descriptive.

Methods

Thirty-nine pregnant women with 40 foetuses in whom ultrasound indicated possible foetal congenital abnormalities were examined by ultra-fast MR scanning within two weeks of the ultrasound scan. The research was carried out from July 1997 to December 1999 in the Free University Medical Centre in Amsterdam, the Netherlands and the Leiden Academic Hospital, the Netherlands. Two techniques were used: the HASTE-Inversion Recovery sequence, and FISP-2D. After delivery, the MRI findings were compared with the postnatal diagnosis, and the extent to which the prenatal MRI findings supplemented the information provided by the ultrasound scan was also examined.

Results

The average gestation period was 27 weeks (SD: 3; range: 19-39). MRI provided additional information about 22 foetuses (10/19 suspected brain abnormality; 6/9 suspected vertebral column abnormality). In nine cases, MRI confirmed the ultrasound findings, in four cases it gave a false-negative result and in two cases it was unable to provide a diagnosis (2/4 skeletal images). Finally, in three cases the procedure was aborted due to maternal claustrophobia.

Conclusion

Ultra-fast MRI of the foetus in utero provided additional information about congenital malformations previously suspected with ultrasound scanning, particularly if these involved the central nervous system.