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Fetal MRI Adds Clarity to the Ultrasound Image

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WebMD Health News

Dec. 1, 1999 (Chicago) -- MRI (magnetic resonance imaging) is proving to be a "complementary imaging technique" in cases where fetal ultrasound results are inconclusive, according to two studies presented at the 85th Scientific Assembly and Annual Meeting of the Radiological Society of North America.

Fergus V. Coakley, MBBCh, assistant clinical professor of radiology, University of California, San Francisco, says that when questionable results from ultrasound suggest a liver problem, his institution uses MRI. In one case, a baby was delivered early after a problem was detected. He says the early delivery allowed treatment, which averted the need for a liver transplant. "Without the diagnosis by MRI, a transplant would have been unavoidable," he says.

At Brigham and Women's Hospital in Boston, Mary C. Frates, MD, assistant professor of radiology, Harvard Medical School, is using MRI to assess central nervous system (CNS) and genital/urinary abnormalities. Frates says that MRI is useful in "adding information that is not obtainable with just ultrasound, even though ultrasound is a very useful tool." In her study she presented results of 13 MRI evaluations done on 35 pregnant women who were referred for MRI following ultrasound. Nine of the cases involved suspected CNS disorders, and the MRI confirmed that diagnosis in all cases, she says. "In two of these cases, the MRI provided additional information that assisted management of the cases," she says. In the remaining four cases, the MRI confirmed ultrasound diagnosis of genital/urinary abnormalities.

Frates says that sometimes the MRI can be useful in easing parental concerns. In two of her cases, women had previously delivered babies with brain damage. They wanted to have their current pregnancies checked out, but the ultrasound examinations in both of these women were inconclusive. "With MRI we were able to confirm that the fetuses were normal," Frates says.

In Coakley's study, 44 women were referred for MRI. The MRI confirmed ultrasound findings in 36 cases and added additional information in 12 of those cases. Moreover, the MRI clarified results in four cases in which the ultrasound findings were inconclusive. In two cases, MRI added information that was not available through ultrasound.

"MRI is especially useful in confirming diagnosis," says Frates. "It is harder to see inside the brain as the fetus gets older if you are using just ultrasound, but MRI overcomes this difficulty."

Frates adds that when ultrasound indicates a problem, "it is not unusual to have an MRI scheduled for immediately after birth. But many of these fetuses are quite ill when they are born and are on ventilators. It is difficult to take an ICU [intensive care unit] baby and put him or her inside the MRI. But when the fetus is inside the mother, it is in a stable environment, and we can put the mother inside the magnet. It's a better option."

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