Additional value of fetal magnetic resonance imaging in the prenatal diagnosis of central nervous system anomalies: a systematic review of the literature. (21st August 2014)

• Record Type: Journal Article
• Authors: Rossi, A. C.; Prefumo, F.
• Is Part Of: Ultrasound in obstetrics & gynecology. Volume 44:Number 4(2014:Oct.)
• Page Start: 388
• Page End: 393
• Publication Date: 2014-08-21
• Subjects: Ultrasonics in obstetrics -- Periodicals; Generative organs, Female -- Diseases -- Diagnosis -- Periodicals; Diagnosis, Ultrasonic -- Periodicals; Genital Diseases, Female -- ultrasonography -- Periodicals; Ultrasonography, Prenatal -- Periodicals; 618.047543
• DOI: 10.1002/uog.13429
• Languages: English
• ISSNs: 0960-7692

Abstract

<abstract abstract-type="main" id="uog13429-abs-0001"> <title>ABSTRACT</title> <sec id="uog13429-sec-0001" sec-type="section"> <title>Objectives</title> <p id="uog13429-para-0001">To analyze literature on the additional value of fetal magnetic resonance imaging (MRI) in assessing central nervous system (CNS) anomalies suspected by ultrasound.</p> </sec> <sec id="uog13429-sec-0002" sec-type="section"> <title>Methods</title> <p id="uog13429-para-0002">A search was performed of PubMed, EMBASE, Cochrane library and the reference lists of identified articles. Inclusion criteria were CNS anomalies suspected/diagnosed by ultrasound, MRI performed after ultrasound, and postmortem examination by autopsy or postnatal assessment. MOOSE guidelines were followed. Outcomes assessed were positive/negative agreement between ultrasound and MRI, additional information provided by MRI, and discordance between ultrasound and MRI. Pooled sensitivity and specificity of MRI were calculated using the DerSimonian–Laird method. Postnatal/postmortem examinations were used as the reference standard.</p> </sec> <sec id="uog13429-sec-0003" sec-type="section"> <title>Results</title> <p id="uog13429-para-0003">We identified thirteen articles which included 710 fetuses undergoing both ultrasound and MRI. MRI confirmed ultrasound‐positive findings in 65.4% of fetuses and provided additional information in 22.1%. MRI disclosed CNS anomalies in 18.4% of fetuses. In 2.0% of cases, ultrasound was more accurate than MRI. In 30% of fetuses, MRI was so different from ultrasound that the clinical management changed. Agreement was observed mainly for ventriculomegaly (51.3%). Disagreement was noted mainly for midline anomalies (48.6%). Pooled sensitivity of MRI was 97% (95% CI, 95–98%) and pooled specificity was 70% (95% CI, 58–81%).</p> </sec> <sec id="uog13429-sec-0004" sec-type="section"> <title>Conclusions</title> <p id="uog13429-para-0004">MRI supplements the information provided by ultrasound. It should be considered in selected fetuses with CNS anomalies suspected on ultrasound. Copyright © 2014 ISUOG. Published by John Wiley & Sons Ltd.</p> </sec> </abstract>