Foetal brain imaging: ultrasound or MRI. A comparison between magnetic resonance imaging and a dedicated multidisciplinary neurosonographic opinion.
OBJECTIVE
(i) To compare original foetal brain ultrasound findings with a multidisciplinary expert opinion; (ii) to compare the multidisciplinary expert ultrasound opinion with foetal magnetic resonance imaging (MRI) findings and (iii) to determine in which circumstances foetal MRI gives additional information, and in how many cases management is changed by having information from MRI.


METHODS
Ultrasound scans of 51 consecutive foetuses where foetal brain MR had been performed were retrospectively reviewed by a panel consisting of maternal-foetal-medicine (MFM) consultants, a geneticist, neonatologists and MFM subspecialty trainees. The original ultrasound opinion was compared with the multidisciplinary opinion, which was then compared with MRI findings. In the cases where MRI gave additional information, an assessment was made as to whether this changed management.


RESULTS
The multidisciplinary ultrasound opinion differed from the original opinion in 9 of 51 (17%) cases. In 19 patients (37%), the MRI gave additional information to the original ultrasound, in 7 (13%) cases, management, and in 7 (13%) cases, counselling was altered by additional information gained from MRI. The multidisciplinary ultrasound and MRI diagnoses were similar in 36 cases (71%).


CONCLUSIONS
Multidisciplinary review of an apparently abnormal foetal brain ultrasound can provide additional diagnostic information. When compared with this level of ultrasound expertise, MRI gave additional information in 29% of cases, but only resulted in change in management in about 13%.
Hagmann
Cornelia F
CF
Centre for Perinatal Brain Research, Institute for Women's Health, University College London, London WC1E 6HX, UK. cornelia.hagmann@ucl.ac.uk
Robertson
Nicola J
NJ
Leung
Wee C
WC
Chong
Kling W
KW
Chitty
Lyn S
LS
D061085:Agenesis of Corpus Callosum; D001921:Brain / Q000002:abnormalities / Q000196:embryology*; D002552:Cerebral Ventricles / Q000002:abnormalities / Q000000981:diagnostic imaging; D003337:Corpus Callosum / Q000000981:diagnostic imaging; D003560:Cysts / Q000000981:diagnostic imaging / Q000196:embryology; D004453:Echoencephalography; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D011237:Predictive Value of Tests; D011247:Pregnancy; D012017:Referral and Consultation; D012189:Retrospective Studies; D016216:Ultrasonography, Prenatal