P20.02: Fetal magnetic resonance imaging—reasons for referral

Abstract

Methods: This was a retrospective analysis of all cases that had fetal MRI between Jan 2008–Dec 2009 to see if MRI added further value to the suspected diagnosis and if it changed further management. Results: Data was analyzed for 53 cases. 5 cases (9.4%) had MRI twice in pregnancy. In 41/53 (77%) cases, MRI was for CNS anomalies. Commonest indication was mild ventriculomegaly (VM) (n = 16, 30.2%), ‘isolated’ in 15 cases. MRI added further information in only 2 cases – ruled out absent CSP and ACC in one case and revealed presence of subependymal bleed in one case. For moderate and severe VM (n = 10, 18.8%), MRI added diagnosis of schizencephaly in one case only. Therefore for VM group, added extra information which changed management was in 3 (11.5%) cases. In 4 cases (7.5%), MRI was done for ? vermian dysgenesis. It confirmed diagnosis in 3 (75%) and excluded diagnosis in 1 case (25%). For cystic brain lesions (n = 4, 7.5%), MRI confirmed presence in 3 (75%) and excluded in 1 case (25%). In 7 (13.2%) cases, MRI was done for other CNS indicationsenlarged CSP, dilated 4th ventricle, microcephaly, cerebral dysgenesis & intracranial bleed. It excluded lesion in 2 (28.6%) and provided additional information in 5 (71.4%) cases. MRI following a single fetal death in monochorionic twins did not add any further information in 2 cases (3.8%). For non CNS indications (n = 7, 13.2%), MRI added value in 2 cases (28.6%). Overall, MRI changed management in 16/53 cases (30.2%). MRI contributed to decision to terminate pregnancy in 3 cases. Conclusions: In about one third of cases MRI added value and contributed to planning management and is therefore is a useful adjunct to ultrasound imaging in selected cases.