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Fast MR imaging and ultrafast MR imaging of fetal central nervous system abnormalities
M Shakudo1, Y Inoue, K Mochizuki
1Department of Radiology, Osaka City General Hospital, Osaka, Japan.
Abstract:
The aims of this study were two: (1) to compare the efficacy of fast MRI (breath-hold fast spin-echo T2-weighted and fast gradient-echo T1-weighted sequence) and ultrafast MRI (half-Fourier acquisition single-shot turbo spin-echo sequence) in evaluation of fetal central nervous system (CNS) abnormalities at late gestational age, and (2) to compare the capability of fast MRI and ultrafast MRI to assess fetal CNS abnormalities with that of prenatal ultrasonography (US). Forty-nine women with fetuses at gestational ages of 26-39 weeks underwent fast MRI (29 patients) or ultrafast MRI (20 patients). In detection of motion artifact, visualization of the lateral and 4th ventricles, and differentiation between gray and white matter in cerebral hemispheres, ultrafast MRI was significantly superior to fast MRI (p< 0.0001, Mann-Whitney U test). In 25 of 43 cases, US and MR diagnoses were the same and consistent with postnatal diagnosis. In 10 of 43 cases, MRI demonstrated findings additional to or different from those of US, and MR findings were confirmed postnatally. MRI, particularly ultrafast MRI, is useful for demonstrating CNS abnormalities in situations in which US is suggestive but not definitive.
Insights
Ultrafast MRI significantly outperforms fast MRI in detecting fetal central nervous system (CNS) abnormalities, offering superior visualization and differentiation. This advanced MRI technique aids in diagnosing complex fetal CNS conditions when prenatal ultrasonography is inconclusive.
Area of Science:
- Medical Imaging
- Radiology
- Fetal Medicine
Background:
- Prenatal diagnosis of fetal central nervous system (CNS) abnormalities is crucial for timely intervention.
- Conventional MRI sequences can be limited by fetal movement in late gestation.
- Ultrasonography (US) is a primary screening tool but may lack definitive diagnostic capabilities for subtle CNS anomalies.
Purpose of the Study:
- To compare the efficacy of fast MRI and ultrafast MRI in evaluating fetal CNS abnormalities at late gestational ages.
- To assess the diagnostic capability of fast and ultrafast MRI against prenatal US for fetal CNS abnormalities.
Main Methods:
- A comparative study involving 49 pregnant women with fetuses between 26-39 weeks gestational age.
- Patients underwent either fast MRI (n=29) or ultrafast MRI (n=20) for fetal CNS evaluation.
- Results were compared between MRI techniques and with prenatal US, validated by postnatal diagnoses.
Main Results:
- Ultrafast MRI demonstrated significantly superior performance over fast MRI in detecting motion artifact, visualizing ventricles, and differentiating gray-white matter (p<0.0001).
- MRI findings were consistent with US in 25/43 cases and provided additional diagnostic information in 10/43 cases, confirmed postnatally.
- Ultrafast MRI enhanced the diagnostic accuracy for fetal CNS abnormalities.
Conclusions:
- Ultrafast MRI is a valuable tool for assessing fetal CNS abnormalities in late gestation, offering improved image quality and diagnostic confidence.
- MRI, especially ultrafast techniques, is particularly useful when prenatal US findings are suggestive but not definitive.
- This study highlights the potential of advanced MRI to refine prenatal diagnosis of fetal neurological conditions.