Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Arch Gynecol Obstet. 2012 Dec;286(6):1443-52. doi: 10.1007/s00404-012-2474-4. Epub 2012 Aug 9.
Our aim was to compare the value of fetal magnetic resonance imaging (MRI) with detailed ultrasound in the prenatal diagnosis of congenital abnormalities.
This retrospective study reviewed the medical records of pregnant women and their neonates who, after ultrasound, were suspected to have congenital abnormalities. They then underwent a detailed ultrasound examination and a fetal MRI in our institutions. Fetal MRI was performed in 81 cases. Each prenatal presumptive diagnosis, based on detailed ultrasound examination and fetal MRI, was compared with the postnatal confirmed diagnosis. In 58 cases, the data collected were confirmed by the postnatal diagnosis.
Supplemental information from fetal MRI was useful in 17 of the 22 cases involving the central nervous system (CNS), two of two cases involving the thorax, nine of nine cases involving the genitourinary system, two of eight cases involving the gastrointestinal system, and ten of ten cases involving complex malformations. Fetal MRI did not provide significantly useful information or facilitate a more accurate diagnosis except for CNS abnormalities.
Fetal MRI was not superior to an ultrasound examination in the prenatal detection of congenital abnormalities. A detailed ultrasound examination performed by experienced obstetricians had satisfactory accuracy in the diagnosis of fetal abnormalities compared with fetal MRI. Fetal MRI might be useful in appropriate cases in Korea. Greater effort is required to increase the ultrasound knowledge and skill of competent obstetricians.
本研究旨在比较胎儿磁共振成像（MRI）与详细超声在产前诊断先天性异常中的价值。
本回顾性研究分析了在超声检查后疑似存在先天性异常的孕妇及其新生儿的病历资料。这些患者随后在我院接受了详细超声检查和胎儿 MRI 检查。81 例患者进行了胎儿 MRI 检查。基于详细超声检查和胎儿 MRI 检查的产前推测诊断与产后确诊诊断进行了比较。58 例患者的数据经产后诊断证实。
在涉及中枢神经系统（CNS）的 22 例、涉及胸部的 2 例、涉及泌尿生殖系统的 9 例、涉及胃肠道系统的 8 例和涉及复杂畸形的 10 例中，胎儿 MRI 提供了有用的补充信息。除 CNS 异常外，胎儿 MRI 并未提供显著有用的信息或有助于更准确的诊断。
胎儿 MRI 在产前检测先天性异常方面并不优于超声检查。与胎儿 MRI 相比，经验丰富的产科医生进行的详细超声检查在胎儿异常诊断方面具有令人满意的准确性。在韩国，胎儿 MRI 在某些特定情况下可能有用。需要加大力度提高有能力的产科医生的超声知识和技能。
