Advertisement

Pediatric Radiology

, Volume 36, Issue 9, pp 927–933 | Cite as

Imaging the fetal spine using in utero MR: diagnostic accuracy and impact on management

  • Paul D. GriffithsEmail author
  • Elysa Widjaja
  • Martyn N. J. Paley
  • Elspeth H. Whitby
Original Article

Abstract

Background

In-utero MR imaging (iuMR) has entered the clinical arena during the last decade. It is used mainly for imaging fetal brain abnormalities.

Objective

To report our experience of imaging the fetal spine and spinal cord in fetuses with known or suspected abnormalities diagnosed on US imaging.

Materials and methods

Prospective imaging and retrospective analysis of the possible impact on management of 50 consecutive fetuses with spinal abnormalities detected by antenatal US imaging.

Results

In 40 (80%) of 50 fetuses, iuMR and US imaging were in complete agreement. In the other 10 fetuses (20%), iuMR provided additional information or changed the diagnosis, including 8 fetuses where the iuMR could find no abnormality and was found to be correct by later follow-up.

Conclusion

IuMR is useful in fetuses with a suspected spinal abnormality. The clinical impact of iuMR may be numerically less than with brain abnormalities, but is still sufficient to warrant its use, especially if there is any uncertainty about the US imaging, and particularly as a relatively high proportion of diagnoses on US imaging are false-positives.

Keywords

Spine Congenital Myelomeningocele MRI Fetus 

Notes

Acknowledgements

The authors would like to thank SPARKS, Sir Jules Thorn, and Sheffield’s Special Trustees, all of whom supported this study financially. We also wish to thank the staff from all of the participating centres whose hard work made the study possible.

References

  1. 1.
    Whitby E, Paley MN, Davies N, et al (2001) Ultrafast magnetic resonance imaging of central nervous system abnormalities in utero in the second and third trimester of pregnancy: comparison with ultrasound. Br J Obstet Gynecol 108:519–526CrossRefGoogle Scholar
  2. 2.
    Whitby EH, Paley MN, Sprigg A, et al (2004) Comparison of ultrasound and magnetic resonance imaging in 100 singleton pregnancies with suspected brain abnormalities. Br J Obstet Gynecol 111:784–792Google Scholar
  3. 3.
    Griffiths PD, Variend D, Evans M, et al (2003) Postmortem MR imaging of the fetal and stillborn central nervous system. AJNR 24:22–27PubMedGoogle Scholar
  4. 4.
    Coakley FV, Glenn OA, Qayyum A, et al (2004) Fetal MRI: a developing technique for the developing patient. AJR 182:243–252PubMedGoogle Scholar
  5. 5.
    Girard N, Gire C, Sigaudy S, et al (2003) MR imaging of acquired fetal brain disorders. Childs Nerv Syst 19:490–500PubMedCrossRefGoogle Scholar
  6. 6.
    Breysem L, Bosmans H, Dymarkowski S, et al (2003) The value of fast MR imaging as an adjunct to ultrasound in prenatal diagnosis. Eur Radiol 13:1538–1548PubMedCrossRefGoogle Scholar
  7. 7.
    Ertl-Wagner B, Lienemann A, Strauss A, et al (2002) Fetal magnetic resonance imaging: indications, technique, anatomical considerations and a review of fetal abnormalities. Eur Radiol 12:1931–1940PubMedGoogle Scholar
  8. 8.
    Garel C, Chantrel E, Elmaleh M, et al (2003) Fetal MRI: normal gestational landmarks for cerebral biometry, gyration and myelination. Childs Nerv Syst 19:422–425PubMedCrossRefGoogle Scholar
  9. 9.
    Simon EM, Goldstein RB, Coakley FV, et al (2000) Fast MR imaging of fetal CNS anomalies in utero. AJNR 21:1688–1698PubMedGoogle Scholar
  10. 10.
    Hubbard AM (2001) Magnetic resonance imaging of fetal thoracic abnormalities. Top Magn Reson Imaging 12:18–24PubMedCrossRefGoogle Scholar
  11. 11.
    Hubbard AM, Adzick NS, Crombleholme TM, et al (1999) Congenital chest lesions: diagnosis and characterization with prenatal MR imaging. Radiology 212:43–48PubMedGoogle Scholar
  12. 12.
    Aaronson OS, Hernanz-Schulman M, Bruner JP, et al (2003) Myelomeningocele: prenatal evaluation – comparison between transabdominal US and MR imaging. Radiology 227:839–843PubMedCrossRefGoogle Scholar
  13. 13.
    Mangels KJ, Tulipan N, Tsao LY, et al (2000) Fetal MRI in the evaluation of intrauterine myelomeningocele. Pediatr Neurosurg 32:124–131PubMedCrossRefGoogle Scholar
  14. 14.
    Simon EM (2004) MRI of the fetal spine. Pediatr Radiol 34:712–719PubMedCrossRefGoogle Scholar
  15. 15.
    McLone DG, Dias MS (2003) The Chiari II malformation: cause and impact. Childs Nerv Syst 19:540–550PubMedCrossRefGoogle Scholar
  16. 16.
    McLone DG (2003) The etiology of neural tube defects: the role of folic acid. Childs Nerv Syst 19:537–539PubMedCrossRefGoogle Scholar
  17. 17.
    Griffiths PD, Wilkinson ID, Variend S, et al (2004) Differential growth rates of the cerebellum and posterior fossa assessed by post mortem magnetic resonance imaging of the fetus: implications for the pathogenesis of the Chiari 2 deformity. Acta Radiol 45:236–242PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Paul D. Griffiths
    • 1
    Email author
  • Elysa Widjaja
    • 1
  • Martyn N. J. Paley
    • 1
  • Elspeth H. Whitby
    • 1
  1. 1.Academic Unit of Radiology, Royal Hallamshire HospitalUniversity of SheffieldSheffieldUK

Personalised recommendations