Zeynep Kamil Med J. 2020; 51(2): 73-77 | DOI: 10.16948/zktipb.611941

The Role of Fetal Magnetic Resonance Imaging in Prenatal Diagnosis

Miraç Özalp¹, ÖMER DEMÝR², Gülseren Dinç², Hidayet Þal², Turhan Aran¹, Mehmet Armaðan Osmanaðaoðlu¹, Sibel Kul^3
1Karadeniz Technical University Faculty of Medicine, Perinatology Clinic, Trabzon, Turkey
²Karadeniz Technical University Faculty of Medicine, Department of Obstetrics and Gynecology, Trabzon, Turkey
³Karadeniz Technical University Faculty of Medicine, Department of Radiology, Trabzon, Turkey

INTRODUCTION: The aim of this study is to investigate the fetal MRI indications preferred by clinicians in our tertiary care center and to reveal the additional diagnostic contribution of MRI to ultrasound findings.
METHODS: Between 2016-2018, 322 cases who underwent fetal MRI were evaluated retrospectively. Fetal lesions were classified according to organ systems and indications of clinicians were determined. Prenatal fetal ultrasound and MRI results were evaluated.
RESULTS: Distribution of indications of 322 fetuses with fetal MRI; Central nervous system anomalies in 138 (42.8%), placental anomalies in 99 (30.7%), genitourinary system anomalies in 36 (11.2%), respiratory system anomalies in 18 (5.6%), 17 (5.3%) maternal factor, 13 (4.0%) head, neck, face anomalies and 1 (0.4%) fetal factor. When all indications were examined, 13 (4.03%) patients had additional findings with MRI. Central nervous system anomalies were the most common additional finding with 7 cases,
fetal MRI contributed 5.07% in this group. There were 3 additional findings (8.33% additional contribution) in the group with genitourinary system abnormalities, 2 additional findings (11.7% additional contribution) in the maternal indications group and 1 additional finding (5.55% additional contribution) in the group with respiratory system anomalies, respectively.
DISCUSSION AND CONCLUSION: Fetal MRI is increasingly used for proper perinatal management and counseling in cases where ultrasonography is inadequate. The availability of MRI devices, the increase in expertise in this field and the advancements in MRI technology will result in the more widespread use of this modality in the field of Perinatology.

Keywords: prenatal diagnosis, fetal magnetic resonance imaging, fetal ultrasonography

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Prenatal Tanýda Fetal Manyetik Rezonans Görüntülemenin Rolü

Miraç Özalp¹, ÖMER DEMÝR², Gülseren Dinç², Hidayet Þal², Turhan Aran¹, Mehmet Armaðan Osmanaðaoðlu¹, Sibel Kul^3
1Karadeniz Teknik Üniversitesi Týp Fakültesi, Perinatoloji Kliniði, Trabzon, Türkiye
²Karadeniz Teknik Üniversitesi Týp Fakültesi, Kadýn Hastalýklarý ve Doðum Anabilim Dalý, Trabzon, Türkiye
³Karadeniz Teknik Üniversitesi Týp Fakültesi, Radyoloji Anabilim Dalý, Trabzon, Türkiye

GÝRÝÞ ve AMAÇ: Üçüncü basamak merkezimizde klinisyenler tarafýndan tercih edilen fetal MRG endikasyonlarýnýn incelenmesi ve MRG’nin ultrason bulgularýna olan ek tanýsal katkýsýnýn ortaya konmasýdýr.
YÖNTEM ve GEREÇLER: 2016-2018 yýllarý arasýnda fetal MRG yapýlan 322 olgu retrospektif olarak incelendi. Fetal lezyonlar organ sistemlerine göre sýnýflandýrýldý ve klinisyenlerin endikasyonlarý belirlendi. Prenatal dönemde yapýlan fetal ultrason ve MRG sonuçlarý deðerlendirildi.
BULGULAR: MRG çekilen 322 fetüsün endikasyonlarýnýn daðýlýmý; 138’inde (%42.8) santral sinir sistemi anomalileri, 99’unda
(%30.7) plasental anomaliler, 36’sýnda (%11.2) genitoüriner sistem anomalileri, 18’inde (%5.6) solunum sistemi anomalileri,
17’sinde (%5.3) maternal faktör, 13’ünde (%4) baþ, boyun, yüz anomalileri ve 1’inde (%0.4) fetal faktör olarak belirlendi. Tüm endikasyonlar incelendiðinde MRG ile ek bulgu saptanan olgu sayýsý 13’tür (%4.03). Santral sinir sistemi anomalileri
7 olgu ile en sýk ek bulgu saptanan gruptur, bu grup içerisinde fetal MRG %5.07 oranýnda ek katký sunmuþtur. Sýrasýyla genitoüriner sistem anomalileri olan grupta 3 ek bulgu (%8.33 oranýnda ek katký), maternal endikasyonlar grubunda 2 ek bulgu (%11.7 oranýnda ek katký) ve solunum sistemi anomalileri olan grupta 1 ek bulgu (%5.55 oranýnda ek katký) olduðu
görüldü.
TARTIÞMA ve SONUÇ: Ultrasonografinin yetersiz kaldýðý hallerde uygun perinatal yönetim ve danýþmanlýk için fetal MRG giderek artan sýklýkta kullanýlmaktadýr. MR cihazlarýnýn daha ulaþýlabilir olmasý, bu alandaki uzmanlýðýn artmasý ve MRG teknolojisindeki ileri geliþmeler, bu modalitenin perinatoloji alanýnda daha yaygýn kullanýmý ile sonuçlanacaktýr.

Anahtar Kelimeler: prenatal taný, fetal manyetik rezonans görüntüleme, fetal ultrasonografi

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