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Fetal MRI versus postnatal imaging in the MR-compatible incubator
Monika Bekiesinska-Figatowska1, Anna Romaniuk-Doroszewska2, Agnieszka Duczkowska2
1Department of Diagnostic Imaging, Institute of Mother and Child, ul. Kasprzaka 17a, 01-211, Warsaw, Poland. zaklad.rtg@imid.med.pl.
Introduction:
One of the aims of fetal magnetic resonance imaging (MRI) is to avoid postnatal scanning. However, clinicians sometimes wish to have postnatal confirmation of prenatal findings. This study's purpose was to check whether there was indeed the added value of neonatal MRI performed in the MR-compatible incubator (INC) after fetal examination.
Materials And Methods:
Material consists of 25 neonates (14 girls) who underwent prenatal and postnatal MRI in a 1.5 T scanner, the latter in INC. Mean time of prenatal MRI was 30th gestational week, of postnatal MRI-16th day of life.
Results:
In 14 cases (56 %) postnatal findings were the same as prenatal ones. In 11 (44 %) postnatal MRI showed some different/new/more precise results, in two the differences were attributed to other factors than the advantage of postnatal MRI over prenatal one. Altogether then postnatal results were partly discordant with prenatal ones in 9/25 cases (36 %).
Conclusions:
In most cases there was no added value of postnatal MRI as compared to prenatal one. This value lied in small details that could not have been noticed on prenatal MRI or required contrast medium administration to be noticed. On the other hand, MR examination performed with use of the dedicated neonatal coils in the MR-compatible incubator is a safe and reliable method of visualization of these small details with better spatial resolution thus helping to establish final diagnosis, treatment plan and prognosis.
Insights
Postnatal MRI in an incubator rarely added value over fetal MRI, though it confirmed small details in some cases. Neonatal MRI is safe and reliable for diagnosis, treatment planning, and prognosis.
Area of Science:
- Medical Imaging
- Neonatal Care
- Radiology
Background:
- Fetal MRI aims to prevent postnatal scans, but confirmation is sometimes needed.
- Neonatal MRI in an MR-compatible incubator (INC) is a developing technique.
Purpose of the Study:
- To evaluate the added value of neonatal MRI after fetal MRI.
- To assess the utility of MRI in an INC for postnatal confirmation.
Main Methods:
- 25 neonates underwent both prenatal and postnatal MRI (1.5 T scanner).
- Postnatal MRI was performed in an INC.
- Mean gestational age at prenatal MRI: 30 weeks; mean postnatal age: 16 days.
Main Results:
- 56% of cases showed identical findings between prenatal and postnatal MRI.
- 44% of cases had different, new, or more precise results postnatally.
- 36% of cases had partly discordant results, with differences in 9/25 cases.
Conclusions:
- Postnatal MRI provided limited added value compared to fetal MRI in most cases.
- Added value was observed for subtle details or when contrast was needed.
- MRI in an INC with neonatal coils is safe, reliable, and improves visualization for diagnosis and prognosis.
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