Konjenital Anomalilerin Değerlendirilmesinde Fetal Manyetik Rezonans Görüntülemenin Rolü / Role Of Magnetic Resonance Imaging In The Diagnosis Of Congenital Anomalies

Year 2017, Volume: 39 Issue: 1, 51 - 64, 29.03.2017

Elif Gündoğdu Hasan Yiğit

https://doi.org/10.20515/otd.18786

Abstract

Özet: Bu çalışmada, prenatal ultrasonografi (US)
ile anomali saptanan ya da anomali şüphesi bulunan olguların fetal manyetik
rezonans görüntüleme (MRG) bulgularını değerlendirmek, anomali tespit edilen
fetusların US ve MRG bulgularını karşılaştırmak ve MRG’nin tanısal
yararlılığını araştırmak amaçlanmıştır. Prenatal US incelemesi sonrası çeşitli
nedenlerle ek incelemeye ihtiyaç duyulan 38 gebeye fetal MRG uygulandı. Tetkiki
tolere edemediğinden incelemesi tamanlanamayan 1 gebe çalışma dışı bırakıldı.
US incelemesi dış merkezlerde yapılan olgulara obstetrik US MRG’leri yorumlayan
radyologlar tarafından gerçekleştirildi. US incelemesini takiben 2-10 gün
arasında değişen sürede MRG tetkiki yapıldı. MRG görüntüleri US verilerinden
haberdar iki radyolog tarafından değerlendirildi. MRG bulguları, US bulguları
ve MRG’nin US’ye ek bilgi sağladığı durumlar kaydedildi. Fetal MRG tetkiki
olguların 18’inde (% 48,6) tanıyı değiştirdi. Olguların 8‘inde (% 18,9) ek
anomali tespit edildi. Olguların 8’inde ( % 18,9) US’de konulan ön tanı
desteklendi, ek anomali saptanmadı, ancak daha fazla anatomik detay göstermesi
nedeniyle anomalilerin daha iyi anlaşılması sağlandı. 28 olguda US ve MRG
bulguları postnatal sonuçlar ile karşılaştırıldı. Postnatal standart referans
sonuçlarına göre 28 olgunun 15’inde (% 53,5) hem US, hem MRG ile doğru sonuçlar
elde edildi. Bu 15 olgunun 8’inde ( % 53,3) fetal MRG, US incelemeye ek katkı
sağladı. 28 olgunun 13’ünde ( % 46,4) MRG sonucu postnatal bulgular ile uyumlu
iken, US sonucu postnatal sonuçlar ile uyumlu değildi. US incelemenin tanısal
olarak yetersiz kaldığı ya da saptanan anomalinin tüm bileşenleriyle açıkça
değerlendirilemediği kompleks konjenital anomalili olguların bir kısmında MRG
ile tanı değişmiş, bir kısmında MRG ile US incelemeye ek katkı sağlanmıştır.

Anahtar Kelimeler: Konjenital
Anomali, Manyetik Rezonans İnceleme, Ultrasonografi

Abstract: Evaluating the fetal magnetic resonance imaging ( MRI )
findings of subjects who have anomaly suspicion or detected anomaly in prenatal
ultrasonography (US ), comparing the MRI and US findings of anomaly detected
foetuses and discussing the diagnostic usefulness of MRI were aimed in this
study. 38 pregnant women who were told further investigations are needed after
their prenatal US imaging were done, underwent fetal MRI. One pregnant woman
was excluded from the study due to uncompleted investigation because she
couldn’t tolerate the test. Obstetric US imaging of the participants whose US
imaging were done in another institution, were performed by the radiologists
who assess the MR images for this study. MRI were performed within 2-10 days
after US imaging were done. MR images were assessed by two radiologists who
know about the US findings. MRI findings, US findings and situations that MRI
provides further information in addition to US findings were noted. In 18  of the cases, fetal MRI technique has changed
the diagnosis. In 8 cases (24.3%), additional anomalies were detected. In 8
cases (18.9 %), the pre-diagnosis that has made in US imaging were supported,
additional anomalies weren’t detected but existing anomalies were understood
more clearly with its more anatomical detail revealing feature.In 28 cases, US
and MRI findings were compared with the postnatal findings. According to
postnatal standard reference results, in 15 of 28 cases (53.5%), true results
were obtained via both US and MRI. In 8 of these 15 cases (53.3%) fetal MRI
provided some additional contributions to US . In 13 of 28 cases (46.4%), it’s
understood that, MRI results were compatible with the postnatal findings but US
results were not compatible. In some cases with complex congenital anomaly that
couldn’t be assessed totally or even couldn’t be adequately diagnosed by US,
the diagnosis has been changed with MRI and in some other cases, there was
additional contributions provided over US imaging.

Keywords: Congenital Anomalies,
Magnetic Resonance Imaging, Ultrasonography

Keywords

Konjenital Anomali, Manyetik Rezonans İnceleme

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