Alice Robinson1, Mark Teoh1, Andrew Edwards1,2, Michael Fahey3,4, Stacy Goergen5,6,7. 1. Fetal Diagnostic Unit, Monash Health, Clayton, Victoria, Australia. 2. Department of Obstetrics and Gynaecology, Monash University, Clayton, Victoria, Australia. 3. Department of Paediatrics, Monash University, Clayton, Victoria, Australia. 4. Paediatric Neurology Unit, Monash Health, Clayton, Victoria, Australia. 5. Department of Medical Imaging, School of Clinical Sciences, Monash University, Clayton, Victoria, Australia. 6. Monash Imaging, Monash Health, Clayton, Victoria, Australia. 7. Department of Surgery, School of Clinical Sciences, Monash University, Clayton, Victoria, Australia.
Abstract
OBJECTIVE: This study aimed to determine the additional diagnostic information provided by prenatal (fetal) magnetic resonance imaging (pMRI) following tertiary ultrasound (US) for fetal cranial abnormalities in complicated monochorionic gestations. METHODS: Women with complicated monochorionic gestations complicated by twin-twin transfusion syndrome, co-twin demise (CD), selective intrauterine growth restriction, and/or twin anaemia-polycythaemia sequence who were referred for pMRI after tertiary US were included. Additional diagnostic information by pMRI that changed prognostic counselling was the primary outcome. RESULTS: Thirty-three women with 48 live fetuses had pMRI at a median of 25 weeks (range: 21-29). Three of ten survivors of spontaneous CD, one of eight survivors of CD after twin-twin transfusion syndrome and 1/30 co-survivors had diagnostic information added by pMRI that altered counselling; US was normal in two and in the other three underrepresented parenchymal injury (5/33 = 15%; 95% confidence interval ±0.27-0.03). Additional findings included occipital lobe infarction, hemispheric injury, dural sinus thrombosis, ischaemia-producing polymicrogyria and intraventricular haemorrhage. Another 8/33 women had additional information provided by pMRI that did not alter counselling. CONCLUSION: Prenatal magnetic resonance imaging resulted in changed prognostic counselling in 5/33 pregnancies. Evaluation of incorporation of pMRI into routine surveillance of complicated monochorionic gestations is needed.
OBJECTIVE: This study aimed to determine the additional diagnostic information provided by prenatal (fetal) magnetic resonance imaging (pMRI) following tertiary ultrasound (US) for fetal cranial abnormalities in complicated monochorionic gestations. METHODS:Women with complicated monochorionic gestations complicated by twin-twin transfusion syndrome, co-twin demise (CD), selective intrauterine growth restriction, and/or twin anaemia-polycythaemia sequence who were referred for pMRI after tertiary US were included. Additional diagnostic information by pMRI that changed prognostic counselling was the primary outcome. RESULTS: Thirty-three women with 48 live fetuses had pMRI at a median of 25 weeks (range: 21-29). Three of ten survivors of spontaneous CD, one of eight survivors of CD after twin-twin transfusion syndrome and 1/30 co-survivors had diagnostic information added by pMRI that altered counselling; US was normal in two and in the other three underrepresented parenchymal injury (5/33 = 15%; 95% confidence interval ±0.27-0.03). Additional findings included occipital lobe infarction, hemispheric injury, dural sinus thrombosis, ischaemia-producing polymicrogyria and intraventricular haemorrhage. Another 8/33 women had additional information provided by pMRI that did not alter counselling. CONCLUSION: Prenatal magnetic resonance imaging resulted in changed prognostic counselling in 5/33 pregnancies. Evaluation of incorporation of pMRI into routine surveillance of complicated monochorionic gestations is needed.
Authors: M Segev; B Djurabayev; E Hadi; Y Yinon; S Rabinowicz; C Hoffmann; S Shrot Journal: AJNR Am J Neuroradiol Date: 2022-03-24 Impact factor: 3.825
Authors: Marjolijn S Spruijt; Enrico Lopriore; Ratna N G B Tan; Femke Slaghekke; Frans J C M Klumper; Johanna M Middeldorp; Monique C Haak; Dick Oepkes; Monique Rijken; Jeanine M M van Klink Journal: J Clin Med Date: 2019-08-15 Impact factor: 4.241