Fetal MRI has been widely used in recent years in most countries of the world and is accepted by both gynecologists who monitor pregnancies and expectant mothers, as it is an established method of prenatal imaging, which complements the ultrasound in high-risk pregnancies.
It is considered a safe method if it is performed in the second or third trimester of pregnancy, while it can be performed even on high field MRI scans.
When is it applied?
Fetal MRI scans show if there is a potentially abnormal finding on the pregnancy ultrasound, usually at level B, or if there is a serious family history or abnormal finding in a previous pregnancy. Magnetic resonance imaging is performed in order to confirm the abnormal ultrasound finding and mainly to exclude concomitant abnormalities that are indistinguishable on ultrasound.
Diagnosis
MRI is used to examine the anatomical area of ​​interest in detail and to rule out concomitant abnormalities that may be difficult to detect by ultrasound but adversely affect the fetal prognosis. Each method has strengths and weaknesses in terms of diagnostic value, however, both pregnancy ultrasound and fetal magnetic resonance imaging are complementary ways of imaging examination of the fetus.
Thus, MRI focuses on a specific anatomical area or system of the fetus and not on the whole body like the ultrasound. For example, an MRI of the fetus’s brain or cervix or chest and abdomen or fetal spine is performed. The musculoskeletal system is more difficult to control by magnetic resonance imaging as the method is less accurate in imaging bone structures.
The examination
The expectant mother is invited to come to the MRI after a short fast. It is suggested that she be as relaxed and calm as possible, since her psychological state often affects the “cooperation” and mobility of the fetus. The examination is performed based on specific protocols and under the supervision of a pediatric radiologist.
Recently, the European Society of Pediatric Radiology Fetal Task Force published in a scientific article * the indications of magnetic resonance imaging of the central nervous system in embryos, followed by a similar article for the other indications of other fetal systems. Until recently, there was dichotomy and confusion between different countries due to different legislation but also different practice and application of embryo imaging methods. Early diagnosis and imaging of congenital anomalies or other fetal pathology is essential as it determines the prognosis of the development of these children while often affecting their treatment and family counseling for subsequent pregnancies.
The Department of Pediatric Radiology of MITERA represents the Greek participation in the European Action Group of the Pediatric Radiology Community ESPR, through which scientific information and experience are exchanged and recorded while the data and the application of the method are updated. It is worth mentioning that MITERA performs MRI scans of the fetus for more than a decade with the excellent cooperation of gynecologists, fetal imaging specialists and counseling.
* Authors of the study in the scientific journal Pediatric Radiology, 2021, 51Q2105-2114, doi: 10.1007 / s00247-021-05104-w are in order: Georgia Papaioannou, Willemijn Klein, Marie Cassart and Catherine Garel, all members of the action group for imaging of embryos of the European Pediatric Radiology Community.
Writes:
Georgia Papaioannou Pediatric Radiologist
Director of the Department of Pediatric Radiology MITERA
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