Standardized fetal anatomical examination using magnetic resonance imaging: a feasibility study

Area of Science:

• Medical Imaging
• Fetal Medicine
• Radiology

Background:

• Ultrasound examination guidelines recommend complete fetal anatomical surveys.
• Magnetic resonance imaging (MRI) offers advanced visualization capabilities for fetal assessment.

Purpose of the Study:

• To evaluate the feasibility of performing a standard complete fetal anatomical survey using a standardized MRI protocol.
• To assess the reproducibility of MRI-based fetal anatomical surveys.

Main Methods:

• A standardized MRI protocol was developed based on ultrasound guidelines.
• Prospective testing in 100 women with a median gestational age of 30 weeks.
• Feasibility assessed by two reviewers evaluating 26 anatomical criteria; reproducibility analyzed using agreement statistics.

Main Results:

• High mean scores for MRI fetal anatomical surveys (Reviewer A: 24.6, Reviewer B: 24.2).
• Over 95% of criteria were assessable in most cases (>95% for Reviewer A, 19 criteria for Reviewer B).
• Excellent inter-reviewer agreement (>90% for 22/26 criteria), though cardiac structures (aorta, pulmonary artery) were challenging.

Conclusions:

• Standardized fetal anatomical examination using MRI is feasible and reproducible.
• MRI shows potential for comprehensive fetal anatomical assessment.
• Improvements are necessary for the accurate evaluation of fetal cardiac anatomy via MRI.