Konjenital Anomalilerin Değerlendirilmesinde Fetal Manyetik Rezonans Görüntülemenin Rolü

Bu çalışmada, prenatal ultrasonografi (US) ile anomali saptanan ya da anomali şüphesi bulunan olguların fetal manyetik rezonans görüntüleme (MRG) bulgularını değerlendirmek, anomali tespit edilen fetusların US ve MRG bulgularını karşılaştırmak ve MRG'nin tanısal yararlılığını araştırmak amaçlanmıştır. Prenatal US incelemesi sonrası çeşitli nedenlerle ek incelemeye ihtiyaç duyulan 38 gebeye fetal MRG uygulandı. Tetkiki tolere edemediğinden incelemesi tamanlanamayan 1 gebe çalışma dışı bırakıldı. US incelemesi dış merkezlerde yapılan olgulara obstetrik US MRG'leri yorumlayan radyologlar tarafından gerçekleştirildi. US incelemesini takiben 2-10 gün arasında değişen sürede MRG tetkiki yapıldı. MRG görüntüleri US verilerinden haberdar iki radyolog tarafından değerlendirildi. MRG bulguları, US bulguları ve MRG'nin US'ye ek bilgi sağladığı durumlar kaydedildi. Fetal MRG tetkiki olguların 18'inde (% 48,6) tanıyı değiştirdi. Olguların 8'inde (% 18,9) ek anomali tespit edildi. Olguların 8'inde ( % 18,9) US'de konulan ön tanı desteklendi, ek anomali saptanmadı, ancak daha fazla anatomik detay göstermesi nedeniyle anomalilerin daha iyi anlaşılması sağlandı. 28 olguda US ve MRG bulguları postnatal sonuçlar ile karşılaştırıldı. Postnatal standart referans sonuçlarına göre 28 olgunun 15'inde (% 53,5) hem US, hem MRG ile doğru sonuçlar elde edildi. Bu 15 olgunun 8'inde ( % 53,3) fetal MRG, US incelemeye ek katkı sağladı. 28 olgunun 13'ünde ( % 46,4) MRG sonucu postnatal bulgular ile uyumlu iken, US sonucu postnatal sonuçlar ile uyumlu değildi. US incelemenin tanısal olarak yetersiz kaldığı ya da saptanan anomalinin tüm bileşenleriyle açıkça değerlendirilemediği kompleks konjenital anomalili olguların bir kısmında MRG ile tanı değişmiş, bir kısmında MRG ile US incelemeye ek katkı sağlanmıştır.

Role of Magnetic Resonance Imaging in the Diagnosis of Congenital Anomalies

Evaluating the fetal magnetic resonance imaging ( MRI ) findings of subjects who have anomaly suspicion or detected anomaly in prenatal ultrasonography (US ), comparing the MRI and US findings of anomaly detected foetuses and discussing the diagnostic usefulness of MRI were aimed in this study. 38 pregnant women who were told further investigations are needed after their prenatal US imaging were done, underwent fetal MRI. One pregnant woman was excluded from the study due to uncompleted investigation because she couldn't tolerate the test. Obstetric US imaging of the participants whose US imaging were done in another institution, were performed by the radiologists who assess the MR images for this study. MRI were performed within 2-10 days after US imaging were done. MR images were assessed by two radiologists who know about the US findings. MRI findings, US findings and situations that MRI provides further information in addition to US findings were noted. In 18 of the cases, fetal MRI technique has changed the diagnosis. In 8 cases (24.3%), additional anomalies were detected. In 8 cases (18.9 %), the pre-diagnosis that has made in US imaging were supported, additional anomalies weren't detected but existing anomalies were understood more clearly with its more anatomical detail revealing feature.In 28 cases, US and MRI findings were compared with the postnatal findings. According to postnatal standard reference results, in 15 of 28 cases (53.5%), true results were obtained via both US and MRI. In 8 of these 15 cases (53.3%) fetal MRI provided some additional contributions to US . In 13 of 28 cases (46.4%), it's understood that, MRI results were compatible with the postnatal findings but US results were not compatible. In some cases with complex congenital anomaly that couldn't be assessed totally or even couldn't be adequately diagnosed by US, the diagnosis has been changed with MRI and in some other cases, there was additional contributions provided over US imaging.

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