Prenatal Magnetic Resonance Imaging – Review article
- Hadjidekov, B. Balev
Ultrasonography (US) is widely used nowadays as first method of choice in the evaluation of the fetus due to its safety, speed and cost-effectiveness. However, fetal magnetic resonance (MRI) is suitable to confirm or reject ultrasonographic findings and to evaluate the extention of some pathologies providing detailed anatomical orientation. This review aims to present the expandible complementary role of fetal MRI in the accurate diagnosis in fetal brain, neck and spine, as well in the entire body. Fetal MRI has the capability to distinguish separate fetal organs and structures such as lung, liver, kidney, ovaries and bowel. The opportunity for evaluation of complex cerebral, thoracic, abdominal and pelvic anomalies is discussed. Fetal MRI benefits of excellent soft tissue resolution, large field-of-view (FOV) and relative operator independence, making it thus useful for prenatal diagnosis and counseling, in-utero surgery, postnatal treatment planning and management decision strategies. Conventional MRI sequences are widely applied as they are fast, comparing the long acquisition times of the advanced MRI sequences like diffusion – weighted FLAIR and Spectroscopy. In 3T free-breathing provides much more comfort for the patient. In conclusion, fetal MRI is a valuable adjunct to ultrasonography, can be used to confirm or reject US findings and as a problem-solver method. Fetal MRI has to be performed in US controversies, inadequate US assessment and/or intrinsic US disadvantages, but always as a second method. Fetal movements are the only significant limitation, but patience and repeated series almost always overcomes this problem. Multidisciplinary team collaboration is essential in the management of every case.
Key words: FETAL MAGNETIC RESONANCE. PRENATAL IMAGING, CONGENITAL ANOMALIES