Donald School Journal of Ultrasound in Obstetrics and Gynecology

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VOLUME 5 , ISSUE 3 ( July-September, 2011 ) > List of Articles


Ultrasound vs MRI in Diagnosis of Fetal and Maternal Complications

Aleksandar Cetkovic, Aleksandra Novakov Mikic, Jelena Dukanac Stamenkovic, Ida Jovanovic, Tatjana Stosic Opincal, Dusan Damnjanovic

Keywords : Ultrasound,MRI,Fetal imaging,Prenatal diagnosis

Citation Information : Cetkovic A, Mikic AN, Stamenkovic JD, Jovanovic I, Opincal TS, Damnjanovic D. Ultrasound vs MRI in Diagnosis of Fetal and Maternal Complications. Donald School J Ultrasound Obstet Gynecol 2011; 5 (3):231-242.

DOI: 10.5005/jp-journals-10009-1200

License: CC BY-NC 4.0

Published Online: 01-06-2012

Copyright Statement:  Copyright © 2011; The Author(s).


Ultrasound is the screening modality of choice for the fetal imaging. However, there are circumstances in which an alternative imaging technique is needed for additional information regarding fetal anatomy and pathology as well as different maternal conditions.

Magnetic resonance imaging (MRI) is being increasingly used as correlative imaging modality in pregnancy because it uses no ionizing radiation, provides excellent soft-tissue contrast, and has multiple planes for reconstruction and large field of view, allowing better depiction of anatomy in fetuses with large or complex anomalies.

In this review, we attempted to identify strengths and weaknesses of each modality both from the literature and our own working experience, and to propose to some practical recommendations on when to use which imaging modality.

Both ultrasonography and MRI are operator-dependant and neither technique obviates the need for thorough knowledge of normal and abnormal anatomy. In early pregnancy, and where repeated assessment is needed, ultrasound has the obvious advantage. In circumstances where ultrasound examination is difficult, as in the obese patient or severe oligohydramnion, better images might be obtained by MRI examination. MRI might also identify early fetal ischemic lesions after an insult, such as maternal trauma or death of a monochorionic co-twin. From the published literature, it would appear that MRI may provide additional diagnostic information to that given by ultrasound in 25 to 55% of cases, which in turn may have influence on parental counseling and/or management of affected pregnancies. Individual circumstances and expertise influence the accuracy of both modalities. Ultrasound and MRI should be performed to the highest possible standard, and the final diagnosis should be made in a multidisciplinary setting.

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  1. Fetal neuroimaging: Ultrasound, MRI, or both. Obstet Gynecol Sur 2008;63:733-45.
  2. Evaluation of real-time single-shot fast spin echo MRI for visualization of the fetal midline corpus callosum and secondary palate. AJR 2006;187:1505-11.
  3. MR imaging of acquired fetal brain disorders. Childs Nerv Syst 2003;19:490-500.
  4. Methods of fetal MR: Beyond T2-weighted imaging. Eur J Radiol 2006;57:172-81.
  5. Fetal central nervous system anomalies: MR imaging augments sonographic diagnosis. Radiology 1997;204:635-42.
  6. Ultrafast scan magnetic resonance in prenatal diagnosis. Fetal Diagn Ther 2000;15:364-72.
  7. Comparison of magnetic resonance imaging and ultrasonography in the prenatal diagnosis of congenital thoracic abnormalities. Featl Diagn Ther 2003;18:447-53.
  8. The value of fast MR imaging as an adjunct to ultrasound in prenatal diagnosis. Eur Radiol 2003;13:1538-48.
  9. Fetal anomalies: Comparison of MR imaging augments sonographic diagnosis. Radiology 2004;232:398-404.
  10. Third-trimester fetal MRI in isolated 10-to 12-mm ventriculomegaly: Is it worth it? BJOG 2006; 113:942-47.
  11. The use of combined ultrasound and magnetic resonance imaging in the detection of fetal anomalies. Prenat Diagn 2010;30:402-07.
  12. Fetal brain imaging: A comparison between magnetic resonance imaging and dedicated neurosonography. Ultrasound Obstet Gynecol 2004;23:333-40.
  13. Craniosynostosis: Prenatal diagnosis by means of ultrasound and SSSE-MRI. Family series with report of neurodevelopmental outcome and review of the literature. Arch Gynecol Obstet 2010;21:234-41.
  14. Development of fetal brain sulci and gyri: Assessment through two and three-dimensional ultrasound and magnetic resonance imaging. Arch Gynecol Obstet 2010;19: 137-43.
  15. Fetal MRI of central nervous system: Clinical relevance. Childs Nerv Syst 2009;25:165-71.
  16. Fetal magnetic resonance imaging: A review. Curr Op Obstet Gynecol 2007;19:151-56.
  17. Ventricular dilatations. Childs Nerv Syst 2003;19:571-23.
  18. Coronal measurement of the fetal lateral ventricles: Comparison between ultrasonography and magnetic resonance imaging. Ultrasound Obstet Gynecol 2006;27:23-27.
  19. Comparison of ultrasound and magnetic resonance imaging in 100 singleton pregnancies with suspected brain abnormalities. BJOG 2004;111:784-92.
  20. Diagnostic value of prenatal MRI in fetus with intracranial anomalies diagnosed by ultrasonography. Ned Tijdschr Geneeskd 2001;145:179-84.
  21. Outcome of antenatally diagnosed intracranial hemorrhage case series and review of the literature. Ultrasound Obstet Gynecol 2003;22:121-30.
  22. Fast MR imaging of fetal CNS anomalies in utero. AJNR 2000;21:1688-99.
  23. The role of magnetic resonance imaging in the evaluation of isolated mild ventriculomegaly. J Ultrasound Med 2004;23:519-23.
  24. Magnetic resonance imaging supplements ultrasonographic imaging of the posterior fossa, pharynx and neck in malformed fetuses. Ultrasond Obste Gynecol 1999;13:327-34.
  25. Fetal anomalies: Comparison of MRI imaging and US diagnosis. Radiology 2004;232:398-404.
  26. Complex fetal disorder: Effect of MR imaging on management-preliminary clinical experience. Radiology 1999;213:691-96.
  27. Second-opinion magnetic resonance imaging for suspected fetal central nervous system abnormalities. Am J Obstet Gynecol 2003;188:492-96.
  28. Correlation of fetal frontal lobe and transcerebellar diameter measurements: The utility of a new prenatal sonographic technique. Ultrasound Obstet Gynecol 1997;10:94-97.
  29. Prenatal diagnosis of microcephaly assisited by vaginal sonography and power Doppler. Ultrasound Obstet Gynecol 1998;11:357-60.
  30. Fast MR imaging of fetal central nervous system abnormalities. Radiology 2003;229: 51-61.
  31. Prenatal diagnosis of polymicrogyria by fetal magnetic resonance imaging in monochorionic twin pregnancies. J Ultrasound Med 2005;24:711-16.
  32. Frontal bilateral megalencephaly: Fetal and autopsy MR evaluation of an unclassified malformation. Prenat Diagn 2005;25:489-91.
  33. Sonographic cerebral sulcai pattern in normal fetuses. J Radiol 2006;87:49-55.
  34. Cortical maturation in normal and abnormal fetuses as assessed with prenatal MR imaging. Radiology 1999;210:751-58.
  35. Diffusion-weighted magnetic resonance imaging of cerebral white matter development. Eur J Radiol 2003;45:235-43.
  36. MRI of fetal acquired lesions. Eur J Radiol 2006;57:233-49.
  37. Fetal schizencephaly: Preand postnatal imaging with a review of the clinical manifestations. Radiographics 2005;25:647-55.
  38. Characteristics associations and outcome of partial agenesis of the corpus callosum in the fetus. Ultrasound Obstet Gynecol 2006;27:509-16.
  39. Prenatal sonographic imaging of an immature intracranial teratoma. Fetal Diagn Ther 1999;14:220-22.
  40. Diffusion-weighted MR of the brain: Methodology and clinical application. Radiol Med 2005;109:155-97.
  41. Longitudinal CT and MR appearances of hemimegalencephally in a patient with tuberous sclerosis. Childs Nerv Syst 2008;24:397-401.
  42. Brain vascular malformations in the fetus: Diagnosis and prognosis. Childs Nerv Syst 2003;19:524-28.
  43. Brain magnetic imaging response acutely to hypoxia-ischemia predicts postnatal outcome. Ann Neurol 2007;61:307-14.
  44. MR imaging of acquired fetal brain disorders. Childs Nerv Syst 2003;19:490-500.
  45. Fetal stroke. Pediatr Neurol 2004;30:151-62.
  46. Intracranial hemorrhage progressing to porencephaly as a result of congenitally acquired cytomegalovirus infection–an illustrative report. Prenat Diagn 2003;23:797-800.
  47. Fetal cytomegalovirus infection of the brain: The spectrum of sonographic findings. AJNR 2003;24:28-32.
  48. Focal sonographic periventricular pattern associated with mild ventriculomegally in fetal CMV infection revealing cytomegalic encephalitis in third trimester of pregnancy. Prenat Diagn 2004;24:727-32.
  49. Cytomegalovirus-related fetal brain lesions: Comparison between targeted ultrasound examination and magnetic resonance imaging. Ultrasound Obstet Gynecol 2008;32: 900-05.
  50. Value of prenatal ultrasound and magnetic resonance imaging in assessment of congenital primary cytomegalovirus infection. Ultrasound Obstet Gynecol 2010;36:709-17.
  51. Major brain lesions by intrauterine herpes simplex virus infection: MRI contribution. Prenat Diagn 2007;27:81-84.
  52. Spinal dysraphism: A review of neuroradiological features with embryological correlations and proposal for a new classification. Neuroradiology 2000;42:471-91.
  53. Prenatal screening and diagnosis of neural tube defects. Prenat Diagn 2009;29:402-11.
  54. Fetal evaluation of spine dysraphism. Pediatr Radiol 2010;40:1029-37.
  55. Prenatal prognosis of congenital diaphragmatic hernia using magnetic resonance imaging measurement of fetal lung volume. Ultrasound Obstet Gynecol 2005;26:738-44.
  56. Fetal echocardiography: A sophisticated tool in obstretics. Minerva Cardioangiol 2005;53:129-38.
  57. Technique of fetal echocardiography. Pediatr Cardiol 2004;25:223-33.
  58. Methodological study on real-time three-dimensional echocardiography and its application in the diagnosis of complex congenital heart disease. Chin Med J 2006;119:1190-94.
  59. Potential role of fetal cardiac evaluation with magnetic resonance imaging: Preliminary experience. Prenat Diagn 2008;28:148-56.
  60. MR imaging characteristics of the normal fetal gastrointestinal tract and abdomen. Eur J Radiol 2008;65:170-81.
  61. Fetal gastrointestinal MRI: All that glitters in T1is not necessarily colon. Pediatr Radiol 2010;40:1215-21.
  62. Magnetic resonance imaging of the intrauterine fetal genitourinary tract: Normal anatomy and pathology. Abdom imaging 2004;29:286-302.
  63. Mesoblastic nephroma: Prenatal ultrasonographic and MRI features. Pediatr Radiol 2000;30:147-50.
  64. Complementary roles of prenatal sonography and magnetic resonance imaging in diagnosis of fetal renal anomalies. Austral NZ J Obstet Gynaecol 2010;50:237-41.
  65. Fetal MRI of the placenta in extreme early onset IUGR. Prenat Diagn 2010;30:384-86.
  66. J Mag Res Imag 2006;24:1-15.
  67. Adnexal torsion: Magnetic resonance findings the viable adnexa with emphasis on stromal ovarian appearance. J Magn Reson Imaging 2004;20:451-62.
  68. MR imaging of maternal diseases of the abdomen and pelvis during pregnancy and the immediate postpartum period. Radiographics 2004;24:1301-16.
  69. Preoperative local staging of endometrial cancer: Transvaginal sonography vs magnetic resonance imaging. Ultrasound Obstet Gynecol 2008;31:560-66.
  70. Radiologic staging in patients with endometrial cancer: A metaanalysis. Radiology 1999;212:711-18.
  71. New models to predict depth of infiltration in endometrial carcinoma based on transvaginal sonography. Ultrasound Obstet Gynecol 2006;27:664-971.
  72. Magnetic resonance imaging in evaluating functional disorders of female pelvic floor. Radiol Med 2002;103:488-500.
  73. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J 2010;21:5-26.
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