Fetal brain imaging: A comparison between fetal ultrasonography and intra uterine magnetic resonance imaging (a systematic review and meta‐analysis)

Abstract

Objective The aim of this study was to compare ultrasound (US) and intra uterine MRI (IUMRI) of the brain in the diagnosis of fetal brain abnormalities. Methods The present systematic review is done based on guidelines for preferred reporting items for systematic reviews and meta‐analysis. All major articles comparing fetal US with IUMRI in fetuses with suspected brain abnormalities were qualified. Articles published before 2010 were excluded from the study. An I2 > 20% was considered as a sign of significant change. The statistical analysis was done using STATA −15 and Meta‐Disk 1.4 applications. Results Five articles were considered for meta‐analysis. The sensitivity of US and IUMRI in diagnosing fetal abnormalities were 86% and 95%, respectively. The corresponding rates for specificity were 77% and 80%. IUMRI and US were concordant in 72.5% (95% CI: 68%–77%) of diagnoses. However, IUMRI added information in 21.7% of cases, while US added value was only 1.48. Conclusion Our results approved the good diagnostic performance of both US and IUMRI in confirming fetal brain normal development and emphasized that US is an appropriate screening technique in pregnancy. In cases of detected abnormalities in US, IUMRI is suggested as it was the most accurate imaging method and added information about the diagnosis in 22.2% of cases.

Voxel‐based morphometric magnetic resonance imaging evaluation of small head fetus: A comparative study with normal developmental fetus

“…Because of its low cost and simple operation, ultrasound (US) examination is a method of prenatal malformation screening (Moradi et al, 2022). The major limitation for central nervous system screening by US is that acoustic wave is shaded by calvarium or spine, resulting in acquiring high-resolution image with difficulty.…”

Does diabetes mellitus affect the development of fetal brain structures and spaces including corpus callosum, subarachnoid space, insula, and parieto‐occipital fissure?

“…During neurosonographic evaluation, measurements related to the corpus callosum (CC), subarachnoid space, insula, and parieto-occipital fissure depths in the axial image are primarily used in neurosonographic research. [9][10][11][12] However, further studies are needed to comprehensively assess the fetal intracranial structures and spaces with additional planes to increase the reliability of the correlation between the detected measurement differences and structural defects, especially in women with DM, which has a remarkable potential to cause fetal brain abnormalities. 8,13 To date, no published study has undertaken an assessment of brain structures in women with DM at gestational ages beyond 20 weeks, with particular emphasis on simultaneous measurements of CC width and depth in the midsagittal image; and lateral craniocortical (LCC) and posterior craniocortical (PCC) widths of the subarachnoid space and insular and parieto-occipital fissure depths in the axial image.…”

“…The various intracranial structures and spaces, which technical advances in neurosonography have made it possible to measure, are increasingly being taken into account in the study of disorders of brain development during fetal life. During neurosonographic evaluation, measurements related to the corpus callosum (CC), subarachnoid space, insula, and parieto‐occipital fissure depths in the axial image are primarily used in neurosonographic research 9–12 . However, further studies are needed to comprehensively assess the fetal intracranial structures and spaces with additional planes to increase the reliability of the correlation between the detected measurement differences and structural defects, especially in women with DM, which has a remarkable potential to cause fetal brain abnormalities 8,13 .…”

The combined use of ultrasound with magnetic resonance in the study of fetal brain: From the diagnosis towards the prognosis and beyond!

“…In the meta-analysis published on the current issue of this Journal, Behnaz Moradi et al 1 reviewed the evidence in literature on the diagnostic accuracy of ultrasound and fetal magnetic resonance imaging (MRI) in diagnosing CNS abnormalities and found five studies reporting a sensibility of 86% and 95% for ultrasound and MRI, respectively, thus highlighting the overall good detection rate of both imaging tool and confirming the slightly better performance of fetal MRI for fetal brain lesions. 1 CNS anomalies are among the most common congenital anomalies diagnosed during fetal life, with an incidence of about one to two cases per 1000 births and ultrasound has always been the main modality to help diagnose fetal CNS anomalies. 2,3 Ultrasound is the gold standard imaging modality for fetal brain and with the advent of 3D technique it is possible to obtain a detailed view of axial, sagittal and coronal plane with an excellent reproducibility 4,5 and an easy approach by the use a semiautomatic tools.…”

“…In the meta‐analysis published on the current issue of this Journal, Behnaz Moradi et al 1 reviewed the evidence in literature on the diagnostic accuracy of ultrasound and fetal magnetic resonance imaging (MRI) in diagnosing CNS abnormalities and found five studies reporting a sensibility of 86% and 95% for ultrasound and MRI, respectively, thus highlighting the overall good detection rate of both imaging tool and confirming the slightly better performance of fetal MRI for fetal brain lesions 1 …”