Susceptibility-weighted imaging to evaluate normal and abnormal vertebrae in fetuses: A preliminary study

Area of Science:

• Magnetic Resonance Imaging (MRI)
• Fetal Imaging
• Spinal Anatomy

Background:

• Fetal vertebral anomalies require accurate in utero diagnosis.
• Standard MRI sequences like HASTE and TrueFISP have limitations in visualizing subtle spinal structures.
• Susceptibility-weighted imaging (SWI) offers potential for improved contrast and detail.

Purpose of the Study:

• To evaluate the performance of SWI in visualizing normal and abnormal fetal vertebrae in utero.
• To compare the diagnostic efficacy of SWI against conventional MRI sequences (HASTE/TrueFISP).
• To assess the correlation between fetal vertebral ossification and gestational age.

Main Methods:

• SWI, TrueFISP, and HASTE sequences were acquired on 1.5-T MRI in 97 women with normal fetal vertebrae and 127 with suspected anomalies.
• Image quality and diagnostic performance of SWI were compared to HASTE/TrueFISP.
• Pearson correlations were used to assess the relationship between L1 centrum ossification center (COC) measurements and gestational age (GA).

Main Results:

• SWI demonstrated significantly greater visibility of fetal vertebral structures compared to HASTE and TrueFISP (p < 0.001).
• Diagnostic accuracy of SWI (89.0%) was superior to HASTE/TrueFISP (48.0%) (p < 0.001), with an AUC of 0.909.
• Fetal L1 COC dimensions and area showed a significant linear correlation with gestational age (p < 0.001).

Conclusions:

• SWI is a reliable MRI technique for depicting fetal vertebral structure and growth.
• SWI significantly enhances the diagnostic performance for fetal vertebral anomalies.
• This method aids in the accurate assessment of spinal development in utero.