Does whole-body in-utero MRI in those with suspected fetal abnormalities improve antenatal care? A single-centre retrospective cohort study.

IF 3.6 2区 医学 Q1 PEDIATRICS
Hang Cheong Derek Ng, Christopher Harris, Victoria Stern, Anthony R Hart, Elspeth Helen Whitby
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引用次数: 0

Abstract

Objective: To determine whether full body in-utero MRI (iuMRI) rather than targeted imaging adds useful clinical information when a fetal anomaly is suspected in the brain or the body.

Design: Single-centre retrospective cohort study, from October 2011 to May 2022.

Setting: Regional fetal MRI service in Sheffield, UK.

Patients: All pregnant people undergoing iuMRI.

Interventions: iuMRI of the brain and body was reviewed by a fetal radiologist, and the results discussed by a multidisciplinary team.

Main outcome measures: Additional abnormalities detected on iuMRI outside of the initial area of interest on ultrasound.

Results: 1876 participants: 916 participants had a fetus with brain anomalies only on ultrasound, of which 12 (1.3%) had additional body abnormalities on iuMRI. 960 participants had body anomalies only on ultrasound, of whom 8 (0.8%) had an additional brain abnormality. The additional findings from 12 cases (0.6% of whole cohort) added useful clinical information to guide care or counselling.

Conclusion: If brain or body anomalies are found on ultrasound in the fetus, whole-body iuMRI reveals additional abnormalities in a small number of cases. However, these may provide important information that changes counselling or care. Further research is required to determine how significant this impact is for clinicians and families, whether normal findings reassure families, how long whole-body iuMRI adds to the MRI acquisition time and the health economics implications.

怀疑胎儿异常的全身子宫内MRI是否能改善产前护理?单中心回顾性队列研究。
目的:确定当怀疑胎儿在大脑或身体中出现异常时,全身子宫内MRI (iuMRI)是否比靶向成像更能提供有用的临床信息。设计:单中心回顾性队列研究,时间为2011年10月至2022年5月。设置:区域胎儿MRI服务在谢菲尔德,英国。患者:所有接受iuMRI的孕妇。干预措施:由胎儿放射科医生审查脑和身体的iuMRI,并由多学科小组讨论结果。主要结果测量:在超声检查的初始感兴趣区域之外,在iuMRI上检测到额外的异常。结果:1876名参与者:916名参与者的胎儿仅在超声上有脑异常,其中12名(1.3%)参与者在iuMRI上有额外的身体异常。960名参与者仅在超声上有身体异常,其中8人(0.8%)有额外的大脑异常。来自12例(占整个队列的0.6%)的额外发现增加了有用的临床信息,以指导护理或咨询。结论:如果超声检查发现胎儿脑或身体异常,在少数情况下,全身iuMRI显示额外的异常。然而,这些可能提供改变咨询或护理的重要信息。需要进一步的研究来确定这种影响对临床医生和家庭有多重要,正常的发现是否让家庭放心,全身iuMRI增加了MRI获取时间的多长时间以及健康经济学意义。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
9.00
自引率
4.50%
发文量
90
审稿时长
6-12 weeks
期刊介绍: Archives of Disease in Childhood is an international peer review journal that aims to keep paediatricians and others up to date with advances in the diagnosis and treatment of childhood diseases as well as advocacy issues such as child protection. It focuses on all aspects of child health and disease from the perinatal period (in the Fetal and Neonatal edition) through to adolescence. ADC includes original research reports, commentaries, reviews of clinical and policy issues, and evidence reports. Areas covered include: community child health, public health, epidemiology, acute paediatrics, advocacy, and ethics.
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