Added value of foetal MRI in a multidisciplinary prenatal diagnosis centre

Abstract

Introduction: There are few literature data on the use of foetal MRI in multidisciplinary prenatal diagnosis centres (MPDCs). In 2021 and 2023, the European Society of Paediatric Radiology's Fetal Task Force updated its guidelines on indications for foetal MRI. The objective of the present study was to analyze the indications for foetal MRI and determine the technique's added diagnostic and prognostic value in the management of pregnancies in an MPDC in France.

Method: This retrospective, single-centre study included all patients having undergone ultrasound and foetal MRI assessment in an MPDC (Amiens, France). This MPDC is the only centre in the region that performs foetal MRI.

Result: A total of 243 patients were included between January 1st, 2016, and December 31st, 2022, with no exclusions. The foetal MRI's added diagnostic and prognostic value was classified as null in 63 cases (26%), complementary with no impact on the prognosis in 88 cases (36%), complementary with an impact on the prognosis in 65 cases (27%), and reassignment in 27 cases (10%). MRI modified patient management in 92 (38%) cases. Forty (17%) patients were offered a therapeutic termination of pregnancy.

Conclusion: MRI indicated for abnormal brain findings on ultrasound has a major impact on the prognosis of a pregnancy; this is particularly true for ventriculomegaly and open V4 posterior fossa malformations. In contrast, the investigation of isolated periventricular cysts and unusual aspects of the cavum pellucidum did not appear to constitute relevant indications. Outside the central nervous system, foetal MRI is of value for characterizing diaphragmatic hernias, complex urinary tract malformations, and masses.