Donald School Journal of Ultrasound in Obstetrics and Gynecology

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VOLUME 4 , ISSUE 4 ( October-December, 2010 ) > List of Articles

REVIEW ARTICLE

Antenatal MRI in Clinical Practice: An Update

Nitin P Ghonge, Sanchita Dube

Keywords : Antenatal MRI,Fetal imaging

Citation Information : Ghonge NP, Dube S. Antenatal MRI in Clinical Practice: An Update. Donald School J Ultrasound Obstet Gynecol 2010; 4 (4):433-438.

DOI: 10.5005/jp-journals-10009-1163

License: CC BY-NC 4.0

Published Online: 01-12-2010

Copyright Statement:  Copyright © 2010; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

By definition, antenatal MRI is the MR imaging during state of gestation without causing any significant risk to ongoing pregnancy and the fetus. MRI is in a unique advantageous position during antenatal period where ultrasound often provides limited information and CT is usually avoided due to radiation-related risks. The indications of antenatal MRI can be sub-divided into fetal indications, maternal obstetric indications and maternal non-obstetric indications. Antenatal MRI offers better anticipation of prognosis and facilitates parental counseling by accurate characterization of disease process and detection of concomitant anomalies. Ultrasound will however, remain the primary fetal imaging modality and MRI is not likely to replace its role in fetal imaging because of the proven utility, widespread availability and relatively low cost of ultrasound. But under specific clinical conditions, where Ultrasound does not provide adequate information, MRI is bliss and is a useful adjunct to ultrasound.

The specific clinical indications where MRI proved to be more useful include fetal anomaly screening in high risk/precious pregnancy, oligohydramnios / maternal obesity, fetal CNS assessment, characterization of fetal mass, assessment of fetal spine, delineation of fetal alimentary tract and other abdominal viscera, conjoint twin assessment, prior to antenatal intra-uterine fetal surgery or ex-utero intrapartum procedure. MRI indications which are presently at relatively experimental stage include non-invasive MR spectroscopy to detect antenatal fetal hypoxia and lung maturity status. Apart from this, the role of Diffusion-weighted MRI in antenatal imaging of placenta and fetal kidneys/lungs is also likely to emerge in near future. In addition, antenatal MRI also evaluates the maternal pelvis and provides vital information about fetal-pelvic disproportion.

By virtue of recent advances in MR technology and the need to practice evidence-based medicine, antenatal MRI is now rapidly moving from the realms of select academic medical centers into community practice in India. The article provides a brief update on antenatal MRI in routine clinical practice.


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  1. Fetal MRI: Seeing What Ultrasound Doesn't. Radiology Today, 2005;6(2):18.
  2. Fetal MRI: A developing technique for the developing patient; AJR 2004;182:243-52.
  3. Obstetric MR Imaging, Radiology 1999;211:609-17.
  4. AJR 2002;178:1335-47.
  5. Development of daily rhythmicity in heart rate and locomotor activity in the human fetus. J Circadian Rhythms 2005;3:5.
  6. Optimization of Acquisition Time for MRI of Fetal Head: The Eyes Have It. AJR 2005;185:1060-62.
  7. Magnetic Resonance Imaging in the Evaluation of Fetuses Referred for Sonographically Suspected Abnormalities of the Corpus Callosum. J Ultrasound Med 2005;24:791-804.
  8. Fetal Lung-to-Liver Signal Intensity Ratio at MR Imaging: Development of a Normal Scale and Possible Role in Predicting Pulmonary Hypoplasia in Utero. Radiology 2005;235:1005.
  9. VIBE MRI for Evaluating the Normal and Abnormal Gastrointestinal Tract in Fetuses. AJR 2007;189:W303-08.
  10. Placenta Accreta: Spectrum of US and MR imaging findings. RadioGraphics 2008;28:1905-16.
  11. MRI of Acute Abdominal and Pelvic Pain in Pregnant Patients. AJR 2005;184:452-58.
  12. The Fetus at Term: In Utero Volume-selected Proton MR Spectroscopy with a Breath-hold Technique: A Feasibility Study. Radiology 2001;219:563-66.
  13. Feasibility of magnetic resonance spectroscopy for evaluating fetal lung maturity. Jour of Ped Surg. Apr 2006;41(4):768-73.
  14. MRI with diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) assessment in the evaluation of normal and abnormal fetal kidneys: Preliminary experience. Prenat Diagn 2007 Dec;27(12):1104-11.
  15. Placental Pathologies in Fetal MRI with Pathohistological Correlation. Placenta. June 2009;30(6):555-59.
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