Fetal Central Nervous System Anomalies Detected by Magnetic Resonance Imaging: A Two-Year Experience|
Sefidbakht, Sepideh; Dehghani, Sakineh; Safari, Maryam; Vafaei, Homeira & Kasraeian, Maryam
Background: Magnetic resonance imaging (MRI) is gradually becoming more common for thorough visualization of the fetus than
ultrasound (US), especially for neurological anomalies, which are the most common indications for fetal MRI and are a matter of
concern for both families and society.
Objectives: We investigated fetal MRIs carried out in our center for frequency of central nervous system anomalies. This is the first
such report in southern Iran.
Materials and Methods: One hundred and seven (107) pregnant women with suspicious fetal anomalies in prenatal ultrasound entered
a cross-sectional retrospective study from 2011 to 2013. A 1.5 T Siemens Avanto scanner was employed for sequences, including
T2 HASTE and Trufisp images in axial, coronal, and sagittal planes to mother’s body, T2 HASTE and Trufisp relative to the specific fetal
body part being evaluated, and T1 flash images in at least one plane based on clinical indication. We investigated any abnormality
in the central nervous system and performed descriptive analysis to achieve index of frequency.
Results: Mean gestational age ± standard deviation (SD) for fetuses was 25.54 ± 5.22 weeks, and mean maternal age ± SD was 28.38
± 5.80 years Eighty out of 107 (74.7%) patients who were referred with initial impression of borderline ventriculomegaly. A total of 18
out of 107 (16.82%) patients were found to have fetuses with CNS anomalies and the remainder were neurologically normal. Detected
anomalies were as follow: 3 (16.6%) fetuses each had the Dandy-Walker variant and Arnold-Chiari II (with myelomeningocele). Complete
agenesis of corpus callosum, partial agenesis of corpus callosum, and aqueductal stenosis were each seen in 2 (11.1%) fetuses.
Arnold-Chiari II without myelomeningocele, anterior spina bifida associated with neurenteric cyst, arachnoid cyst, lissencephaly,
and isolated enlarged cisterna magna each presented in one (5.5%) fetus. One fetus had concomitant schizencephaly and complete
agenesis of the corpus callosum.
Conclusions: MRI is superior to ultrasound and physical exam of live births in detection of CNS anomalies. In this investigation
within a single referral center in southern Iran, anomalies included Dandy-Walker variant and Arnold-Chiari II as the most common
findings. Other findings with lower incidence were complete and partial agenesis of corpus callosum, aqueductal stenosis, anterior
spina bifida, schizencephaly, arachnoid cyst, lissencephaly, and isolated enlarged cisterna magna.
Fetus; MRI; CNS Anomalies