Verburg Bero, Fink A Michelle, Reidy Karen, Palma-Dias Ricardo
Fetal Medicine Unit, The Royal Women's Hospital, Melbourne, Vic., Australia.
Fetal Diagn Ther. 2015;38(3):186-94. doi: 10.1159/000380821. Epub 2015 Apr 1.
The aim of this study was to investigate the additional value of fetal magnetic resonance imaging (MRI) in the assessment and management of fetuses with abnormal findings on ultrasound.
A total of 257 patients who had fetal MRI following the ultrasound diagnosis of a fetal anomaly, or were at high risk, were included. The patients were grouped by referral category for fetal MRI. Fetal MRI was compared to ultrasound in the detection of anomalies, i.e. whether additional findings were identified and if this changed diagnosis, prognosis and management during pregnancy.
Ultrasound findings were confirmed on fetal MRI in 89% of the cases. Additional findings were seen with MRI in 28% of all patients. The diagnosis changed in 21% and the prognosis in 19% of the cases. Perinatal management changed in 8%. The antenatal findings were confirmed in all cases that had a postmortem examination following termination of pregnancy. In all the pregnancies that continued to delivery and for which the postnatal outcome is known, the findings correlated in 97% of the cases.
Fetal MRI provided additional detection of fetal anomalies, leading to a change in diagnosis and prognosis in 19% of the cases. Neonatal and postmortem findings mostly confirmed the fetal MRI diagnosis, suggesting it to be a useful tool for clinical decision making in perinatal management.
本研究的目的是探讨胎儿磁共振成像（MRI）在评估和管理超声检查发现异常的胎儿中的附加价值。
共有257例在超声诊断胎儿异常后或处于高风险状态下接受胎儿MRI检查的患者纳入研究。根据胎儿MRI的转诊类别对患者进行分组。将胎儿MRI与超声在异常检测方面进行比较，即是否发现了额外的异常，以及这是否改变了孕期的诊断、预后和管理。
89%的病例中胎儿MRI证实了超声检查结果。28%的患者通过MRI发现了额外的异常。21%的病例诊断发生了改变，19%的病例预后发生了改变。围产期管理改变的病例占8%。所有在终止妊娠后进行尸检的病例中，产前检查结果均得到证实。在所有继续妊娠至分娩且已知产后结局的病例中，97%的病例检查结果相互关联。
胎儿MRI能够额外检测出胎儿异常，19%的病例中导致了诊断和预后的改变。新生儿和尸检结果大多证实了胎儿MRI诊断，表明它是围产期管理临床决策的有用工具。
