Title: Role of Fetal MRI in detection of CNS anomalies

Authors: Dr Karanbir S Bajwa, Dr Sanjay B Shahu, Dr Avinash P Dhok, Dr Sushupti M Chaukhande,  Dr Purva M Agarwal,  Dr Gurnihal S Chawla

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i2.116

Abstract

Context: Congenital malformation is a stimulating problem for research. The commonest of these are CNS anomalies (1).  The abnormalities detected on Ultrasound may at times be very subtle or inconclusive. In such cases, several studies have shown that MRI is a helpful modality.

Aims: 1.To establish role of MRI in detection and evaluation of CNS anomalies.

2. To assess whether fetal MRI provides additional information to findings detected on USG.

Settings and Design: Cross sectional study

Methods and Material: All pregnant women referred to our department within 2 years, were examined by USG. 36 patients with fetal CNS anomalies detected on USG were subsequently examined by MRI and results were analyzed statistically.

Statistical Analysis Used: Quantitative and Qualitative data are presented with the help of Mean and Standard deviation& frequency and percentage table respectively. Association among study groups is assessed by Fisher test, student ‘t’ test and Chi-Square test. ‘p’ value less than 0.05 is taken as significant.

Results: Ultrasound detected and suspected anomalies in 36 cases of CNS, which were subsequently confirmed or further characterized with some additional information obtained or were concordant on MRI. There were also some cases that turned out to be normal on MRI and some where the MRI findings were totally discordant with the USG findings.

Conclusions: MRI is superior to USG in diagnosing CNS anomalies of the fetus. MRI can add additional diagnostic information to sonography in fetuses for which prenatal intervention is being considered.

Keywords: CNS anomalies, MRI, USG.

References

1.  1.      Temtamy SA, Meguid NA, Mazen I, Ismail SR, Kassem NS, Bassiouni. A R. genetic epidemiological study of malformations at birth in Egypt. East Mediterr Health J, 4 (1998), pp. 252–259.

2.      Chen CJ. Perinatal mortality and prevalence of major congenital malformations of twins in Taipei city Taiwan. Acta Genet Med Gemellol (Roma), 41 (2–3) (1992), pp. 197–203

3.      Drugan A, Krause B, Canady A, Zador I, Sacks A, Evans M. The natural history of prenatally diagnosed cerebral ventriculo-megaly. JAMA, 261 (1989), pp. 1785–1788

4.      Berry KNS, Throrpe-BesstonRSJ, Gosden C. Fetal lateral cerebral ventriculomegaly: associated malformations and chromosomal defects. Fetal DiagnTher, 5 (1990), pp. 5–14

5.      Levine D, Barnes D,Madsen JR, W. Li-Edelman RR. Fetal central nervous system anomalies: MR imaging augments sonographic diagnosis. Radiology, 204 (1997), pp. 35–64

6.      Coakley FV, Glenn OA, QayyumA, Barkovich AJ, GolsteinR, Filly RA, et al. Fetal MRI: a developing technique for the developing patient. AJR Am J Roentgenol, 182 (242–53) (2004), p. 55

7.      Twickler DM, Magee KP, Caire J, M. Zaretsky JL. Fleckenstein RM. Ramus. Second-opinion magnetic resonance imaging for suspected fetal central nervous system abnormalities. Am J ObstetGynecol, 188 (2003), pp. 492–496 .

8.      Fogliarini, CK. Chapon CF et al. Assess-ment of cortical maturation with prenatal MRI. PartI: normal cortical maturation. EurRadiol, 15 (2005), pp. 1671–1685.

9.      Nadine G, Kathia CH, Sylvianne C et al. Magnetic resonance imaging and the detection of fetal brain anomalies, injury, and physiologic adaptations. CurrOpin Obstet Gynecol, 18 (2006), pp. 164–176

10.  McCarthy SM, Filly RA, Stark DD, Callen PW, Golbus MS, Hricak H. Magnetic resonance imaging of fetal anomalies in utero: early experience. AJR, 145 (1985), pp. 677–682

11.  Levin D, Hatbu H, Gaa J, Atkinson M, Edelman R. Fetal anatomy revealed with fast MR sequences. AJR, 167 (1996), pp. 905–908.

Corresponding Author

Dr Karanbir S Bajwa

Lata Mangeshkar Hospital

Hingna Road, Nagpur PIN- 440019

Email: This email address is being protected from spambots. You need JavaScript enabled to view it., Mobile Number-9158023311