Ultrafast magnetic resonance imaging of central nervous system abnormalities in utero in the second and third trimester of pregnancy: comparison with ultrasound

Objective To assess the ability of ultrafast magnetic resonance imaging to visualise abnormalities in the central nervous system of third trimester fetuses in utero and to compare the results with the current 'reference standard' of ultrasound and postnatal imaging or post-mortem data. Design A prospective, observational study comparing the diagnostic accuracy of two imaging methods: antenatal ultrasound and antenatal magnetic resonance with each other and postnatal or post mortem data. Population Twenty-one pregnant women of 19-36 weeks of gestation whose fetus were thought to have a central nervous system abnormality on the basis of antenatal ultrasound. The women had either not been offered or had refused a termination and were willing to have a magnetic resonance scan. Methods A 1.5T magnetic resonance scanner used a single shot fast spin echo sequence, in three image planes. The results were compared with the ultrasound results obtained by an experienced investigator independently. A series of 21 patients, with a range of pathologies of central nervous system: were imaged. Postnatal ultrasound and/or magnetic resonance imaging, or post-mortem data were used for additional confirmation of the pathology in all cases. Results The magnetic resonance report was different to the ultrasound in 10/21 (47.6%), magnetic resonance provided information additional to the ultrasound in 5/21 (23.8%), ultrasound and magnetic resonance results agreed in 6/21 cases (28.6%). Conclusion Magnetic resonance in the third trimester provides a useful adjuvant to ultrasound imaging of the fetus when assessing abnormalities of the central nervous system after 19 weeks of gestation particularly if the abnormality involves the posterior fossa.