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60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit den Benelux-Ländern und Bulgarien

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

24. - 27.05.2009, Münster

Foetal MRI of the central nervous system – clinical relevance

Meeting Abstract

  • M. Messing-Jünger - Neurochirurgische Abteilung, Asklepios Klinik Sankt Augustin
  • A. Röhrig - Neurochirurgische Abteilung, Asklepios Klinik Sankt Augustin
  • R. Stressig - Praenatal, Düsseldorf
  • J. Schaper - Institut für Diagnostische Radiologie, Universitätsklinikum Düsseldorf
  • B. Turowski - Institut für Diagnostische Radiologie, Universitätsklinikum Düsseldorf
  • D. Blondin - Institut für Diagnostische Radiologie, Universitätsklinikum Düsseldorf

Deutsche Gesellschaft für Neurochirurgie. 60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit den Benelux-Ländern und Bulgarien. Münster, 24.-27.05.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. DocMO.08-07

DOI: 10.3205/09dgnc050, URN: urn:nbn:de:0183-09dgnc0503

Veröffentlicht: 20. Mai 2009

© 2009 Messing-Jünger et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: Foetal MRI can be a useful addition to ultrasound screening in pregnancy. Oligohydramnion and physiognomic conditions of the mother sometimes reduce the quality of ultrasound. Foetal MRI is indicated after gestational week (GW) 18, although massive malformations are visible earlier. Interpretation of the findings in respect of subtle disorders or malformations becomes safe not before GW 23. Clinical development of children with CNS disorders is not predictable with imaging alone. Statistical evidence and personal experience of the medical team are essential in parents' counseling, but optimized imaging is helpful in being more precise. The worth of foetal MRI in this context is evaluated.

Methods: In 25 pregnant women (30.5 ± 4.5 y) an additional foetal MRI was performed. Technique: Breath-hold-technique with T2-weighted HASTE and T1-weighted FLASH-2D images in all 3 dimensions with FOV of 350 x 400 mm (1.5 Tesla Magnetom Vision; Siemens Medical Solutions). All cases have been correlated with postnatal MRI or ultrasound and with clinical follow-up.

Results: In all fetuses a diagnostic MRI could be performed 3-10 days after ultrasound between GW 22 and 34 (GW 26.1 ± 3.6). Sedation was not necessary. In 8 cases of suspicious ultrasound MRI confirmed ultrasound findings. In 13 cases important additional diagnoses or exclusions of suspected findings could be established, which was essential for the counselling. Complete revision of the diagnosis was realized in 4 cases. Postnatal MRI in 11 patients could confirm all findings. The clinical course was not predictable in all cases due to the ambivalent prognosis of the underlying pathology.

Conclusions: In prenatal medicine diagnosis of pathologies should result in parental counselling. Sufficient diagnostic information as well as statistical data and experience of the professional team – consisting of radiologists, pre- and neonatal doctors and neurosurgeons are essential. These results show that in detecting congenital CNS-abnormalities foetal MRI is superior to ultrasound and therefore should be considered in difficult cases to enhance evidence. The clinical course cannot be predicted in all cases.