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Complete agenesis of corpus callosum. Gestational age: 27 weeks. (a) Sagittal SSFSE T2. (b) Coronal SSFSE T2. (c) Axial SSFSE T2. Complete agenesis of corpus callosum with right interhemispherical cyst with mass effect (solid black arrow) is shown. The right cerebral hemisphere is smaller in size, and malformation of cortical development is evident, with multiple anomalous sulci, bumpy cortical surface (solid black arrowhead), and cortical invaginations (empty white arrow). Regions of associated polymicrogyria (solid white arrowhead) and heterotopias bulging on the ventricle wall are depicted (solid white arrow). Fetal MRI provides useful information for perinatal management and prognosis over fetal ultrasound by detecting anomalies of the cerebral cortex and heterotopies not visible in the fetal ultrasound.
Source publication
There is some controversy about the value of fetal MRI in prenatal diagnosis, and most of the studies examine its accuracy in central nervous system (CNS) pathology. The objective of this retrospective study was to assess the diagnostic accuracy and usefulness of fetal MRI in the prenatal diagnosis of central nervous system (CNS) pathology and non-...
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Citations
... This may be due to the plethora of studies assessing various aspects of fetal MRI in cases of congenital diaphragmatic hernia but none looking at diagnostic accuracy. Studies that did not fit the criteria for inclusion suggest a range of diagnostic accuracy, however fetal MRI has been shown to be superior to ultrasound in most of these [24,25]. Others have shown how lung lesions change over time making prediction of the histological type difficult [26], leading to many centres providing a description of the lesion at a certain point in time and not a diagnosis. ...
Objectives
To undertake a systematic review to assess the accuracy of fetal MRI in diagnosis of non-CNS congenital anomalies of the fetal body in comparison with antenatal ultrasound when correlated to postnatal diagnosis.
Methods
Searches were conducted from electronic databases, key journals and reference lists for eligible papers. Inclusion criteria was original research studies comparing the diagnostic results of antenatal ultrasound, fetal MRI and final postnatal diagnosis via imaging, surgery or post-mortem testing. Studies of CNS anomalies were excluded. Studies were assessed for risk of bias by two reviewers working independently and data was then extracted by a single reviewer.
Results
12 studies were included with a total of 361 eligible patients who underwent USS and MRI and had a postnatal diagnosis. USS alone had a diagnostic accuracy of 60.6% whereas MRI had an improved diagnostic accuracy of 86.4%. The overall odds ratio was 0.86 (CI 0.202–1.519 and p-value < 0.01).
Conclusion
Fetal MRI makes a significant contribution to accurate diagnosis of congenital abnormalities of the fetal body; especially in genito-urinary anomalies. More research is needed to improve the evidence base for the role of fetal MRI in diagnosis of congenital anomalies in other body systems.
... Fetal Magnetic Resonance Imaging (MRI) offers high soft tissue contrast compared to ultrasound [5,[11][12][13] and provides more comprehensive information [14] for diagnosing specific fetal or maternal abnormalities, such as oligohydramnios or polyhydramnios. The use of MRI in pregnancies is considered safe by the Canadian Association of Radiologists, particularly after the first trimester and without gadolinium-based contrast agents [15]. ...
Amniotic Fluid Volume (AFV) is a crucial fetal biomarker when diagnosing specific fetal abnormalities. This study proposes a novel Convolutional Neural Network (CNN) model, AFNet, for segmenting amniotic fluid (AF) to facilitate clinical AFV evaluation. AFNet was trained and tested on a manually segmented and radiologist-validated AF dataset. AFNet outperforms ResUNet++ by using efficient feature mapping in the attention block and transposing convolutions in the decoder. Our experimental results show that AFNet achieved a mean Intersection over Union (mIoU) of 93.38% on our dataset, thereby outperforming other state-of-the-art models. While AFNet achieves performance scores similar to those of the UNet++ model, it does so while utilizing merely less than half the number of parameters. By creating a detailed AF dataset with an improved CNN architecture, we enable the quantification of AFV in clinical practice, which can aid in diagnosing AF disorders during gestation.
... In agreement to our study, Recio Rodríguez et al., (12) study reported that the diagnostic accuracy of the fetal MRI was higher than that of fetal ultrasound in all cases and all indications. The differences in diagnostic accuracy between fetal ultrasound and fetal MRI were significant for all cases (90.4% vs 97%; p<0.001). ...
... The differences in diagnostic accuracy between fetal ultrasound and fetal MRI were significant for all cases (90.4% vs 97%; p<0.001). In addition Our results agreed with those obtained by Recio Rodríguez et al., (12) study which showed that the diagnostic accuracy of the fetal MRI was higher than that of fetal ultrasound and the differences in diagnostic accuracy between fetal ultrasound and fetal MRI were significant for CNS pathology (89.7% vs 98.1%; p<0.001) while fetal ultrasound and fetal MRI were concordant in 90.2% of the cases. ...
... There was a moderate agreement between prenatal US and prenatal MRI of fetal renal anomalies. This result agreed with Recio Rodríguez et al., (12) study which reported that fetal MRI provided additional over fetal ultrasound in 16.7% of cases. ...
Background; Congenital anomalies are present in 2-4% of newborns and are an important cause of fetal and neonatal mortality and morbidity, Aim and objectives; to compare magnetic resonance imaging to ultrasound in detection of congenital fetal malformations, Subjects and methods; Our prospective randomized control study to compare magnetic resonance imaging to ultrasound in detection of congenital fetal malformations. The was carried out on 100 pregnant women at second and third trimesters who were divided into two equal groups: group A (cases) comprised fetus with congenital anomalies on ultrasound examination and group B (control Group): low risk pregnancies with no detected fetal anomalies on ultrasound examination, Result; Four of patients were diagnosed with congenital anomalies detected by prenatal MRI that differed from that of postnatal diagnosis which represented 8% of all cases and 46 of those cases were diagnosed as same as postnatal diagnosis which represented 92% of all cases. There was no significant difference between prenatal MRI and postnatal diagnosis in detection of prenatal congenital CNS anomalies with p value was 0.123, Conclusion; Fetal MRI has a superior diagnostic accuracy.
... Pregnant women meeting one or more of the following conditions should be considered as a high-risk pregnancy: a previous child with chromosomal abnormalities or other congenital defects, mother or father with a chromosomal abnormality, suffering from an X-linked disease, having a chronic disease such as diabetes or certain endocrine disorders, having a family history of malformations, chromosomal abnormalities or congenital metabolic disorders, suffering from an infection during pregnancy, twin pregnancy, maternal obesity, advanced maternal age (>35 years old), consuming drugs during pregnancy, being exposed to radiation or toxic products for work-related or temporary reasons, assisted reproductive techniques. The possibility of a pregnant woman with one or more of these conditions or having a fetus with a congenital defect is multiplied by a greater or lesser factor that depends on the altered condition detected [1,[4][5][6]. Additionally, suffering from a mental health issue during the perinatal period (i.e., stress, anxiety, depression, psychopathological symptoms, post-traumatic stress disorder) is a risk factor that can have a negative impact on the maternal health and the offspring [7]. ...
Perinatal health is a primary objective for health systems. The perinatal period is a sensitive time for both the mother and the fetus. During pregnancy, delivery, and the postpartum period, numerous physiological and psychological changes take place that can affect maternal and neonatal health. Therefore, there are numerous situations that may have an adverse impact during the perinatal period, which need to be assessed and diagnosed early [1].
Prenatal diagnosis refers to the set of tests that are performed during pregnancy in order to identify the presence of potential congenital defects in the fetus or maternal risk factors that may require strict controls throughout gestation. The early diagnosis of any congenital defect in the fetus allows the most appropriate measures to be taken, both during pregnancy and during delivery, to prevent unnecessary risks for the mother and child and to try to improve the prognosis of the newborn after birth [2]. In some cases, intrauterine treatment of certain congenital defects can nowadays be carried out. Likewise, in the presence of certain fetal pathologies, preparation for receiving the newborn by a multidisciplinary team can improve the postnatal prognosis of the newborn
Background
Fetal ultrasound has limitations, especially if the patient is obese or in cases with oligohydramnios. Magnetic resonance imaging (MRI) can then be used as a complement, but only few studies have focused on examinations in the second trimester.
Purpose
To validate MRI as a complement to diagnose fetal anomalies in the second trimester.
Material and Methods
This retrospective study retrieved data from January 2008 to July 2012 from the Fetal Medicine Unit and Department of Radiology at Uppsala University Hospital. Ultrasound and MRI findings were reviewed in 121 fetuses in relation to the final diagnosis, including postpartum follow-up and autopsy results.
Results
Of the 121 fetuses, 51 (42%) had a CNS anomaly and 70 (58%) a non-CNS anomaly diagnosed or suspected. MRI provided additional information in 21% of all cases without changing the management and revealed information that changed the management of the pregnancy in 13%. When a CNS anomaly was detected or suspected, the MRI provided additional information in 22% and changed the management in 10%. The corresponding figures for non-CNS cases were 21% and 16%, respectively. The proportion of cases with additional information that changed the management was especially high in patients with a BMI >30 kg/m ² (25%) and in patients with oligohydramnios (38%). In five cases in category III, false-positive ultrasound findings were identified.
Conclusions
MRI in the second trimester complements ultrasound and improves diagnosis of fetal CNS- and non-CNS anomalies especially when oligohydramnios or maternal obesity is present.
Objective
Genetic high‐resolution analyses and improved diagnostic imaging have impacted the ability to detect fetal disorders. It is unknown if this resulted in an alteration in the number of terminations of pregnancy due to fetal anomalies (TOPFA). The objective was to describe the incidence and indication of TOPFA.
Methods
A descriptive study based on records from the Regional Abortion Council in the Central Denmark Region from 2008 to 2021 consisting of 1895 TOPFA.
Results
A consistent incidence of TOPFA was observed, accounting for 0.96% of the total births during that period. When examining fetal indications, there was a small increase in the occurrence of genetic aberrations, primarily caused by deletions, duplications, and single nucleotide variations, whereas the number of chromosomal aberrations remained stable. Of 35.5% of the cases with malformations, the central nervous system was the most affected organ system, followed by malformations of the heart 29.6%. Overall, the total number of cases remained stable.
Discussion and conclusion
Unexpectedly, despite the development of new diagnostic tools, the incidence of TOPFA from 2008 to 2021 remained stable. However, the number of cases with genetic aberrations increased. This may be attributed to increased genetic testing for fetuses with identified malformations, resulting in more accurate diagnoses.
Objectives
To assess brain development in living fetuses with Down syndrome (DS) by biometric measurements on fetal brain magnetic resonance images (MRI).
Methods
We scanned 10 MRIs of fetuses with confirmed trisomy 21 at birth and 12 control fetal MRIs without any detected anomalies. Fetal brain MRIs were analyzed using 14 fetal brain and skull biometric parameters. We compared measures between DS and controls in both raw MRIs and motion‐corrected and anterior‐posterior commissure‐aligned images.
Results
In the reconstructed images, the measured values of the height of the cerebellar vermis (HV) and anteroposterior diameter of the cerebellar vermis (APDV) were significantly smaller, and the anteroposterior diameter of the fourth ventricle (APDF) was significantly larger in fetuses with DS than controls. In the raw MRIs, the measured values of the right lateral ventricle were significantly larger in fetuses with DS than in controls. Logistic regression analyses revealed that a new parameter, the cerebellar‐to‐fourth‐ventricle ratio (i.e., (APDV * Height of the vermis)/APDF), was significantly smaller in fetuses with DS than controls and was the most predictive to distinguish between fetuses with DS and controls.
Conclusions
The study revealed that fetuses with DS have smaller cerebellums and larger fourth ventricles compared to the controls.
There is an ongoing need of collecting data on perinatal management and long- term follow-up of children with congenital CMV in order to estimate the true long-term disease burden of this most common congenital infection worldwide. With the Flemish registry, a first important step is taken to achieve this goal. Further studies in a screening-based population will enhance our knowledge even more.
