School of Medicine and Population Health, University of Sheffield, Level 4, Jessop Wing, Tree Root Walk, Sheffield, S10 2SF, UK.
Medical Imaging and Medical Physics, Sheffield Teaching Hospitals, Sheffield, UK.
BMC Med Imaging. 2024 May 16;24(1):111. doi: 10.1186/s12880-024-01286-5.
To undertake a systematic review to assess the accuracy of fetal MRI in diagnosis of non-CNS congenital anomalies of the fetal body in comparison with antenatal ultrasound when correlated to postnatal diagnosis.
Searches were conducted from electronic databases, key journals and reference lists for eligible papers. Inclusion criteria was original research studies comparing the diagnostic results of antenatal ultrasound, fetal MRI and final postnatal diagnosis via imaging, surgery or post-mortem testing. Studies of CNS anomalies were excluded. Studies were assessed for risk of bias by two reviewers working independently and data was then extracted by a single reviewer.
12 studies were included with a total of 361 eligible patients who underwent USS and MRI and had a postnatal diagnosis. USS alone had a diagnostic accuracy of 60.6% whereas MRI had an improved diagnostic accuracy of 86.4%. The overall odds ratio was 0.86 (CI 0.202-1.519 and p-value < 0.01).
Fetal MRI makes a significant contribution to accurate diagnosis of congenital abnormalities of the fetal body; especially in genito-urinary anomalies. More research is needed to improve the evidence base for the role of fetal MRI in diagnosis of congenital anomalies in other body systems.
系统评价胎儿 MRI 在诊断胎儿身体非中枢神经系统先天性异常方面的准确性,将其与产前超声检查结果进行比较,并与产后影像学、手术或尸检诊断结果进行相关性分析。
通过电子数据库、主要期刊和参考文献列表进行检索,筛选出比较产前超声、胎儿 MRI 与产后影像学、手术或尸检诊断结果的原始研究。排除中枢神经系统异常的研究。两名评审员独立评估研究的偏倚风险,然后由一名评审员提取数据。
共纳入 12 项研究,总计 361 名符合条件的患者接受了 USS 和 MRI 检查,并进行了产后诊断。单独使用 USS 的诊断准确性为 60.6%,而 MRI 的诊断准确性则提高到 86.4%。总体比值比为 0.86(CI 0.202-1.519,p 值 < 0.01)。
胎儿 MRI 对胎儿身体先天性异常的准确诊断具有重要意义;特别是在泌尿生殖系统异常方面。需要进一步研究来提高胎儿 MRI 在诊断其他身体系统先天性异常中的作用的证据基础。