The diagnostic role of "in utero" magnetic resonance imaging

Objective: To assess the diagnostic potential of Magnetic Resonance Imaging (MRI) in the management of ultrasonically diagnosed congenital anomalies. Patients and Methods: Ninety-two patients were included into the study afte r the ultrasonic diagnosis of an abnormality. Sixty-three of these patients were affected by an abnormality of the central nervous system (CNS) and 29 by abnormalities in other apparatuses. The GRE technique was used to obtai n TI and T2 star-weighted images. Results and Discussion: Satisfactory imaging was obtained in all but one ca se. In order to define the "reliability" of MRI for a given condition, a di agnostic score was designed and separately given by the obstetrician and th e radiologist involved in the case. MRI scored less than ultrasonography fo r abnormalities of the fetal contour and for large and complex distortion o f the CNS as holoprosencephaly. For subtle midbrain anomalies, as well as f or neuronal migration disorders, MRI definitely was superior to sonography. For other anomalies, as for example congenital diaphragmatic hernia, MRI w as better than conventional techniques in assessing prognosis and outcome, but less reliable in assessing associated anomalies. MRI seems to be a valuable adjunct to us for prenatal diagnosis of only sel ected fetal anomalies and requires precise guidelines in a multidisciplinar y approach to prenatal pathology.