Abstract
BackgroundMagnetic resonance imaging (MRI) examinations are increasingly used in antenatal clinical practice. Incidental findings are a recognized association with imaging and although in some circumstances their identification can alter management, they are often associated with increased anxiety, for both patient and clinician, as well as increased health care costs.ObjectiveThis study aimed to evaluate the incidence of unexpected findings in both the mother and fetus during antenatal MRI examinations.Materials and methodsA retrospective study was undertaken over a five-year period at St.. Thomas’ Hospital in London. Maternal incidental findings were recorded from all clinical reports of all fetal MRIs performed (for clinical reasons and in healthy volunteers) during this period. Fetal incidental findings were recorded only in cases where women with uncomplicated pregnancies were participating as healthy volunteers.ResultsA total of 2,569 MRIs were included; 17% of women had maternal incidental findings. Of these, 1,099 were women with uncomplicated pregnancies who undertook research MRIs as healthy volunteers; fetal incidental findings were identified in 12.3%.ConclusionIncidental findings are a common occurrence in antenatal MRI. Consideration should be given to counseling women appropriately before imaging and ensuring that robust local protocols are in place for follow-up and further management of such cases.
Highlights
Magnetic resonance imaging (MRI) is an increasingly utilized modality in obstetric practice for the further characterization of both fetal and placental abnormalities, as well as for abdominal assessment in women with suspected pathology. It is used in some circumstances where pathology is suspected but ultrasound (US) images may be suboptimal, such as in cases of raised body mass index (BMI) or oligohydramnios [1]
This study aims to characterize the incidence of both maternal and fetal incidental findings in a large sample of pregnancies to facilitate enhanced counseling of women before MR imaging as well as to help inform the creation of care pathways for follow-up when abnormalities are identified
Of the women who had multiple scans in the same pregnancy, 10 women had an additional finding on a subsequent scan (7 cases of a short cervix and 3 cases of mild/moderate hydronephrosis) and 5 had an additional fetal finding (1 case of renal pelvis dilation, 2 matured placenta, 1 fetus was noted to have the cord looped around the neck and 1 had a head circumference >97th centile)
Summary
This study aimed to evaluate the incidence of unexpected findings in both the mother and fetus during antenatal MRI examinations. Materials and methods A retrospective study was undertaken over a five-year period at St. Thomas’ Hospital in London. Maternal incidental findings were recorded from all clinical reports of all fetal MRIs performed (for clinical reasons and in healthy volunteers) during this period. Fetal incidental findings were recorded only in cases where women with uncomplicated pregnancies were participating as healthy volunteers. Results A total of 2,569 MRIs were included; 17% of women had maternal incidental findings. 1,099 were women with uncomplicated pregnancies who undertook research MRIs as healthy volunteers; fetal incidental findings were identified in 12.3%. Conclusion Incidental findings are a common occurrence in antenatal MRI. Consideration should be given to counseling women appropriately before imaging and ensuring that robust local protocols are in place for follow-up and further management of such cases
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