KONJENİTAL ANOMALİLERİN DEĞERLENDİRİLMESİNDE FETAL MANYETİK REZONANS GÖRÜNTÜLEMENİN ROLÜ / ROLE OF MAGNETIC RESONANCE IMAGING IN THE DIAGNOSIS OF CONGENITAL ANOMALIES

Abstract

Ozet: Bu calismada, prenatal ultrasonografi (US) ile anomali saptanan ya da anomali suphesi bulunan olgularin fetal manyetik rezonans goruntuleme (MRG) bulgularini degerlendirmek, anomali tespit edilen fetuslarin US ve MRG bulgularini karsilastirmak ve MRG’nin tanisal yararliligini arastirmak amaclanmistir. Prenatal US incelemesi sonrasi cesitli nedenlerle ek incelemeye ihtiyac duyulan 38 gebeye fetal MRG uygulandi. Tetkiki tolere edemediginden incelemesi tamanlanamayan 1 gebe calisma disi birakildi. US incelemesi dis merkezlerde yapilan olgulara obstetrik US MRG’leri yorumlayan radyologlar tarafindan gerceklestirildi. US incelemesini takiben 2-10 gun arasinda degisen surede MRG tetkiki yapildi. MRG goruntuleri US verilerinden haberdar iki radyolog tarafindan degerlendirildi. MRG bulgulari, US bulgulari ve MRG’nin US’ye ek bilgi sagladigi durumlar kaydedildi. Fetal MRG tetkiki olgularin 18’inde (% 48,6) taniyi degistirdi. Olgularin 8‘inde (% 18,9) ek anomali tespit edildi. Olgularin 8’inde ( % 18,9) US’de konulan on tani desteklendi, ek anomali saptanmadi, ancak daha fazla anatomik detay gostermesi nedeniyle anomalilerin daha iyi anlasilmasi saglandi. 28 olguda US ve MRG bulgulari postnatal sonuclar ile karsilastirildi. Postnatal standart referans sonuclarina gore 28 olgunun 15’inde (% 53,5) hem US, hem MRG ile dogru sonuclar elde edildi. Bu 15 olgunun 8’inde ( % 53,3) fetal MRG, US incelemeye ek katki sagladi. 28 olgunun 13’unde ( % 46,4) MRG sonucu postnatal bulgular ile uyumlu iken, US sonucu postnatal sonuclar ile uyumlu degildi. US incelemenin tanisal olarak yetersiz kaldigi ya da saptanan anomalinin tum bilesenleriyle acikca degerlendirilemedigi kompleks konjenital anomalili olgularin bir kisminda MRG ile tani degismis, bir kisminda MRG ile US incelemeye ek katki saglanmistir. Anahtar Kelimeler: Konjenital Anomali, Manyetik Rezonans Inceleme, 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