Cederlund Frida, Axelsson Ove, Desmond Sara, Amini Hashem, Wikström Johan
Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden.
Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Acta Radiol Open. 2024 May 11;13(5):20584601241248820. doi: 10.1177/20584601241248820. eCollection 2024 May.
Fetal ultrasound has limitations, especially if the patient is obese or in cases with oligohydramnios. Magnetic resonance imaging (MRI) can then be used as a complement, but only few studies have focused on examinations in the second trimester.
To validate MRI as a complement to diagnose fetal anomalies in the second trimester.
This retrospective study retrieved data from January 2008 to July 2012 from the Fetal Medicine Unit and Department of Radiology at Uppsala University Hospital. Ultrasound and MRI findings were reviewed in 121 fetuses in relation to the final diagnosis, including postpartum follow-up and autopsy results.
Of the 121 fetuses, 51 (42%) had a CNS anomaly and 70 (58%) a non-CNS anomaly diagnosed or suspected. MRI provided additional information in 21% of all cases without changing the management and revealed information that changed the management of the pregnancy in 13%. When a CNS anomaly was detected or suspected, the MRI provided additional information in 22% and changed the management in 10%. The corresponding figures for non-CNS cases were 21% and 16%, respectively. The proportion of cases with additional information that changed the management was especially high in patients with a BMI >30 kg/m (25%) and in patients with oligohydramnios (38%). In five cases in category III, false-positive ultrasound findings were identified.
MRI in the second trimester complements ultrasound and improves diagnosis of fetal CNS- and non-CNS anomalies especially when oligohydramnios or maternal obesity is present.
胎儿超声检查存在局限性，尤其是当患者肥胖或羊水过少时。此时磁共振成像（MRI）可作为一种补充手段，但仅有少数研究关注孕中期的检查。
验证MRI作为孕中期诊断胎儿异常的补充手段的有效性。
这项回顾性研究收集了2008年1月至2012年7月于乌普萨拉大学医院胎儿医学科和放射科的资料。对121例胎儿的超声和MRI检查结果与最终诊断进行回顾，包括产后随访及尸检结果。
121例胎儿中，51例（42%）诊断或怀疑有中枢神经系统（CNS）异常，70例（58%）有非CNS异常。MRI在所有病例中有21%提供了额外信息但未改变处理方式，13%提供的信息改变了妊娠处理方式。当检测到或怀疑有CNS异常时，MRI在22%的病例中提供了额外信息，10%改变了处理方式。非CNS病例的相应数字分别为21%和16%。在BMI>30kg/m²的患者（25%）和羊水过少的患者（38%）中，因额外信息而改变处理方式的病例比例尤其高。在III类的5例病例中，发现了超声检查的假阳性结果。
孕中期的MRI可补充超声检查，尤其在存在羊水过少或孕妇肥胖的情况下，能改善胎儿CNS和非CNS异常的诊断。
