Öz
ABSTRACT
Objective
The aim of this
study is to investigate the fetal MRI indications preferred by clinicians in
our tertiary care center and to reveal the additional diagnostic contribution
of MRI to ultrasound findings.
Material and Method
Between
2016-2018, 322 cases who underwent fetal MRI were evaluated retrospectively.
Fetal lesions were classified according to organ systems and indications of
clinicians were determined. Prenatal fetal ultrasound and MRI results were
evaluated.
Results
Distribution of
indications of 322 fetuses with fetal MRI; Central nervous system anomalies in
138 (42.8%), placental anomalies in 99 (30.7%), genitourinary system anomalies
in 36 (11.2%), respiratory system anomalies in 18 (5.6%), 17 (5.3%) maternal
factor, 13 (4.0%) head, neck, face anomalies and 1 (0.4%) fetal factor.
When all
indications were examined, 13 (4.03%) patients had additional findings with
MRI. Central nervous system anomalies were the most common additional finding
with 7 cases, fetal MRI contributed 5.07% in this group. There were 3
additional findings (8.33% additional contribution) in the group with
genitourinary system abnormalities, 2 additional findings (11.7% additional
contribution) in the maternal indications group and 1 additional finding (5.55%
additional contribution) in the group with respiratory system anomalies,
respectively.
Conclusion
Fetal MRI is increasingly
used for proper perinatal management and counseling in cases where
ultrasonography is inadequate. The availability of MRI devices, the increase in
expertise in this field and the advancements in MRI technology will result in
the more widespread use of this modality in the field of Perinatology.
Anahtar Kelimeler
Prenatal diagnosis fetal magnetic resonance imaging fetal ultrasonography
Kaynakça
- Patenaude Y, Pugash D, Lim K, Morin L, Lim K, Bly S, et al.; Diagnostic Imaging Committee, The use of magnetic resonance imaging in the obstetric patient. J Obstet Gynaecol Can. 2014;36(4):349-63.
- Palladini D, Volpe P. Anatomic survey of the fetus and early diagnosis of fetal anomaly. In: Ville edit. Ultrasound of Congenital Fetal Anomalies- Differential Diagnosis and Prognostic Indicators. CRC Press 2014;1:20-21.
- Hedrick HL, Flake AW, Crombleholme TM, Howell LJ, Johnson MP, Wilson RD, et al. History of fetal diagnosis and therapy: Children’s Hospital of Philadelphia experience. Fetal Diagn Ther 2003;18: 65–82.
- Hubbard AM. Ultrafast fetal MRI and prenatal diagnosis. Prenat Diagn. 2003;23: 927–931.
- Salomon LJ, Alfirevic Z, Berghella V, Bilardo C, Hernandez-Andrade E, Johnsen SL, et al. Practice guidelines for performance of the routine mid-trimester fetal ultrasound scan. Ultrasound Obstet Gynecol 2011; 37: 116–126.
- Jakab A, Pogledic I, Schwartz E, Gruber G, Mitter C, Brugger PC, et al. Fetal cerebral magnetic resonance imaging beyond morphology. Semin Ultrasound CT MR 2015;36: 465–475.
- Ray JG, Vermeulen MJ, Bharatha A, Montanera WJ, Park AL. Association between MRI exposure during pregnancy and fetal and childhood outcomes. JAMA 2016; 316: 952–961.
- Reddy UM, Abuhamad AZ, Levine D, Saade GR. Fetal imaging: Executive summary of a Joint Eunice Kennedy Shriver National Institute of Child Health and Human Development, Society for Maternal-Fetal Medicine, American Institute of Ultrasound in Medicine, American College of Obstetricians and Gynecologists, American College of Radiology, Society for Pediatric Radiology, and Society of Radiologists in Ultrasound Fetal Imaging Workshop. Am J Obstet Gynecol 2014; 210: 387–397.
- Bekiesinska-Figatowska M, Romaniuk-Doroszewska A, Duczkowska A, Duczkowski M, Iwanowska B, Szkudlińska-Pawlak S. Fetal MRI versus postnatal imaging in the MR-compatible incubator. Radiol Med. 2016;121(9):719-28.
- P. Trompoukis, N. Papantoniou, C. Chlapoutaki, S. Mesogitis , A. Antsaklis Fetal MRI: is it really helpful? The Journal of Maternal-Fetal & Neonatal Medicine Volume 2012;25:2363-68.
- Cardoen L, De Catte L, Demaerel P, Devlieger R, Lewi L, Deprest J, et al. The role of magnetic resonance imaging in the diagnostic work-up of fetal ventriculomegaly. Facts Views Vis ObGyn 2011;3:159–163.
- Arroyo MS, Hopkin RJ, Nagaraj UD, Kline-Fath B, Venkatesan C. Fetal brain MRI findings and neonatal outcome of common diagnosis at a tertiary care center. JPerinatol. 2019; 39(8):1072-1077.
- Yalçın SE, Yalçın Y, Tola EN, Yavuz A, Akkurt MO, Sezik M, et al. Fetal manyetik rezonans görüntüleme endikasyonlarının incelenmesi. Perinatoloji Dergisi 2018;26:18-24.
- Rossi AC, Prefumo F. Additional value of fetal magnetic resonance imaging in the prenatal diagnosis of central nervous system anomalies: a systematic review of the literature. Ultrasound Obstet Gynecol 2014;44:388–93.
- Griffiths PD, Reeves MJ, Morris JE, Mason G, Russell SA, Poley MN et al. A prospective study of fetuses with isolated ventriculomegaly investigated by antenatal sonography and in utero MR imaging. AJNR Am J Neuroradiol 2010;31:106–111.
- Glenn OA. MR imaging of the fetal brain. Pediatr Radiol 2010;40:68–81.
- Palacios Jaraquemada JM, Bruno CH. Magnetic resonance imaging in 300 cases of placenta accreta: surgical correlation of new findings Acta Obstet Gynecol Scand 2005;84:716–724.
- Pico H, Dabadie A, Bourliere-Najean B, Philip N, Capelle M, Aschero A, et al. Contribution of the foetal uro-MRI in the prenatal diagnosis of uronephropathies. Diagn Interv Imaging. 2014;95(6):573-8.
- Lee TC, Lim FY, Keswani SG, Frischer JS, Haberman B, Kingma PS, et al. Late gestation fetal magnetic resonance imaging-derived total lung volume predicts postnatal survival and need for extracorporeal membrane oxygenation support in isolated congenital diaphragmatic hernia. J Pediatr Surg 2011;46:1165–71.
- Kastenholz KE, Weis M, Hagelstein C, Weiss C, Kehl S, Schaible T et al. Correlation of Observed-to-Expected MRI Fetal Lung Volume and Ultrasound Lung-to-Head Ratio at Different Gestational Times in Fetuses With Congenital Diaphragmatic Hernia . American Journal of Roentgenology. 2016;206:856-866.
- Espinoza J. Fetal MRI and prenatal diagnosis of congenital heart defects. Lancet. 2019;20;393(10181):1574-1576.
Öz
ÖZET
Amaç
Üçüncü basamak
merkezimizde klinisyenler tarafından tercih edilen fetal MRG endikasyonlarının
incelenmesi ve MRG’nin ultrason
bulgularına olan ek tanısal katkısının ortaya konmasıdır.
Gereç ve Yöntem
2016-2018 yılları
arasında fetal MRG yapılan 322 olgu retrospektif olarak incelendi. Fetal
lezyonlar organ sistemlerine göre sınıflandırıldı ve klinisyenlerin
endikasyonları belirlendi. Prenatal dönemde yapılan fetal ultrason ve MRG
sonuçları değerlendirildi.
Bulgular
MRG çekilen 322
fetüsün endikasyonlarının dağılımı; 138’inde (%42.8) santral sinir sistemi
anomalileri, 99’unda (%30.7) plasental anomaliler, 36’sında (%11.2) genitoüriner
sistem anomalileri, 18’inde (%5.6) solunum sistemi anomalileri, 17’sinde (%5.3)
maternal faktör, 13’ünde (%4) baş, boyun, yüz anomalileri ve 1’inde (%0.4)
fetal faktör olarak belirlendi.
Tüm endikasyonlar
incelendiğinde MRG ile ek bulgu saptanan olgu sayısı 13’tür (%4.03). Santral
sinir sistemi anomalileri 7 olgu ile en sık ek bulgu saptanan gruptur, bu grup
içerisinde fetal MRG %5.07 oranında ek katkı sunmuştur. Sırasıyla genitoüriner
sistem anomalileri olan grupta 3 ek bulgu (%8.33 oranında ek katkı), maternal
endikasyonlar grubunda 2 ek bulgu (%11.7 oranında ek katkı) ve solunum sistemi
anomalileri olan grupta 1 ek bulgu (%5.55 oranında ek katkı) olduğu görüldü.
Sonuç
Ultrasonografinin
yetersiz kaldığı hallerde uygun perinatal yönetim ve danışmanlık için fetal MRG
giderek artan sıklıkta kullanılmaktadır. MR cihazlarının daha ulaşılabilir
olması, bu alandaki uzmanlığın artması ve MRG teknolojisindeki ileri gelişmeler,
bu modalitenin perinatoloji alanında daha yaygın kullanımı ile sonuçlanacaktır.
Anahtar Kelimeler
Prenatal tanı fetal manyetik rezonans görüntüleme fetal ultrasonografi
Kaynakça
- Patenaude Y, Pugash D, Lim K, Morin L, Lim K, Bly S, et al.; Diagnostic Imaging Committee, The use of magnetic resonance imaging in the obstetric patient. J Obstet Gynaecol Can. 2014;36(4):349-63.
- Palladini D, Volpe P. Anatomic survey of the fetus and early diagnosis of fetal anomaly. In: Ville edit. Ultrasound of Congenital Fetal Anomalies- Differential Diagnosis and Prognostic Indicators. CRC Press 2014;1:20-21.
- Hedrick HL, Flake AW, Crombleholme TM, Howell LJ, Johnson MP, Wilson RD, et al. History of fetal diagnosis and therapy: Children’s Hospital of Philadelphia experience. Fetal Diagn Ther 2003;18: 65–82.
- Hubbard AM. Ultrafast fetal MRI and prenatal diagnosis. Prenat Diagn. 2003;23: 927–931.
- Salomon LJ, Alfirevic Z, Berghella V, Bilardo C, Hernandez-Andrade E, Johnsen SL, et al. Practice guidelines for performance of the routine mid-trimester fetal ultrasound scan. Ultrasound Obstet Gynecol 2011; 37: 116–126.
- Jakab A, Pogledic I, Schwartz E, Gruber G, Mitter C, Brugger PC, et al. Fetal cerebral magnetic resonance imaging beyond morphology. Semin Ultrasound CT MR 2015;36: 465–475.
- Ray JG, Vermeulen MJ, Bharatha A, Montanera WJ, Park AL. Association between MRI exposure during pregnancy and fetal and childhood outcomes. JAMA 2016; 316: 952–961.
- Reddy UM, Abuhamad AZ, Levine D, Saade GR. Fetal imaging: Executive summary of a Joint Eunice Kennedy Shriver National Institute of Child Health and Human Development, Society for Maternal-Fetal Medicine, American Institute of Ultrasound in Medicine, American College of Obstetricians and Gynecologists, American College of Radiology, Society for Pediatric Radiology, and Society of Radiologists in Ultrasound Fetal Imaging Workshop. Am J Obstet Gynecol 2014; 210: 387–397.
- Bekiesinska-Figatowska M, Romaniuk-Doroszewska A, Duczkowska A, Duczkowski M, Iwanowska B, Szkudlińska-Pawlak S. Fetal MRI versus postnatal imaging in the MR-compatible incubator. Radiol Med. 2016;121(9):719-28.
- P. Trompoukis, N. Papantoniou, C. Chlapoutaki, S. Mesogitis , A. Antsaklis Fetal MRI: is it really helpful? The Journal of Maternal-Fetal & Neonatal Medicine Volume 2012;25:2363-68.
- Cardoen L, De Catte L, Demaerel P, Devlieger R, Lewi L, Deprest J, et al. The role of magnetic resonance imaging in the diagnostic work-up of fetal ventriculomegaly. Facts Views Vis ObGyn 2011;3:159–163.
- Arroyo MS, Hopkin RJ, Nagaraj UD, Kline-Fath B, Venkatesan C. Fetal brain MRI findings and neonatal outcome of common diagnosis at a tertiary care center. JPerinatol. 2019; 39(8):1072-1077.
- Yalçın SE, Yalçın Y, Tola EN, Yavuz A, Akkurt MO, Sezik M, et al. Fetal manyetik rezonans görüntüleme endikasyonlarının incelenmesi. Perinatoloji Dergisi 2018;26:18-24.
- Rossi AC, Prefumo F. Additional value of fetal magnetic resonance imaging in the prenatal diagnosis of central nervous system anomalies: a systematic review of the literature. Ultrasound Obstet Gynecol 2014;44:388–93.
- Griffiths PD, Reeves MJ, Morris JE, Mason G, Russell SA, Poley MN et al. A prospective study of fetuses with isolated ventriculomegaly investigated by antenatal sonography and in utero MR imaging. AJNR Am J Neuroradiol 2010;31:106–111.
- Glenn OA. MR imaging of the fetal brain. Pediatr Radiol 2010;40:68–81.
- Palacios Jaraquemada JM, Bruno CH. Magnetic resonance imaging in 300 cases of placenta accreta: surgical correlation of new findings Acta Obstet Gynecol Scand 2005;84:716–724.
- Pico H, Dabadie A, Bourliere-Najean B, Philip N, Capelle M, Aschero A, et al. Contribution of the foetal uro-MRI in the prenatal diagnosis of uronephropathies. Diagn Interv Imaging. 2014;95(6):573-8.
- Lee TC, Lim FY, Keswani SG, Frischer JS, Haberman B, Kingma PS, et al. Late gestation fetal magnetic resonance imaging-derived total lung volume predicts postnatal survival and need for extracorporeal membrane oxygenation support in isolated congenital diaphragmatic hernia. J Pediatr Surg 2011;46:1165–71.
- Kastenholz KE, Weis M, Hagelstein C, Weiss C, Kehl S, Schaible T et al. Correlation of Observed-to-Expected MRI Fetal Lung Volume and Ultrasound Lung-to-Head Ratio at Different Gestational Times in Fetuses With Congenital Diaphragmatic Hernia . American Journal of Roentgenology. 2016;206:856-866.
- Espinoza J. Fetal MRI and prenatal diagnosis of congenital heart defects. Lancet. 2019;20;393(10181):1574-1576.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Orjinal Araştırma |
| Yazarlar | |
| Yayımlanma Tarihi | 15 Haziran 2020 |
| Yayımlandığı Sayı | Yıl 2020 Cilt: 51 Sayı: 2 |
