Fetal US and MRI in detection of craniospinal anomalies with postnatal correlation: single-center experience

Abstract

Background/aim: To reveal the contribution of magnetic resonance imaging (MRI) to ultrasound (US) in prenatal diagnosis of fetal craniospinal anomalies by retrospectively comparing the prenatal and postnatal findings.

Materials and methods: After institutional review board approval, between January 2010 and May 2020, 301 pregnant women, which had a gestational age between 19–37 weeks (mean 26.5 ± 6.1 weeks), diagnosed with cranial and spinal anomalies on fetal US and later on imaged with MRI were evaluated, and in 179 of those cases prenatal imaging findings were compared with postnatal findings.

Results: A total of 191 fetal craniospinal anomalies were detected in 179 pregnant women. MRI and US diagnosis were completely correct in 145 (75.9%) and 112 (58.6%), respectively. Diagnostic performance of MRI was significantly higher than that of the US (p < 0.05). Both prenatal MRI and US findings were concordant with postnatal diagnosis in 53% of the cases. In 28.7% cases, prenatal MRI contributed to US by either changing the wrong US diagnosis (8.9%), demonstration of additional findings (14%), or confirming the suspicious US diagnosis (5.8%).

Conclusion: Due to its high resolution and multiplanar imaging capability, fetal MRI contributes significantly to US in the correct prenatal diagnosis of craniospinal anomalies. This contribution especially is significant in neural tube defects, cortical malformations, and ischemic-hemorrhagic lesions.

Keywords: Fetal MRI; craniospinal malformations; fetal ultrasound; prenatal diagnosis.

Figure 1

Sagittal T2 HASTE from fetal MR imaging demonstrates severe cerebellar ectopia (white arrows) and large defect in the posterior arch of the thoracic and lumbosacral vertebrae (black arrows). Findings are consistent with Chiari II malformation.

Figure 2

Axial (a) and sagittal (b) T2 HASTE fetal MR images show hydrocephalic dilatation of the lateral ventricles.

Figure 3

Sagittal T2 SSFSE fetal MR image reveals large lumbosacral myelomeningocele sac (arrows).

Figure 4

Sagittal T2 SSFSE fetal MR image demonstrates total agenesis of the corpus callosum.