Fetal central nervous system magnetic resonance imaging at the University Hospital of the West Indies, Jamaica.
BACKGROUND
Compared with ultrasound, magnetic resonance imaging (MRI) offers superior visualization ofthe fetal brain. It confirms and characterizes brain abnormalities detected by prenatal ultrasound, particularly in late pregnancy when acoustic windows are difficult or fetal position is inaccessible. Prior to July 2008, only two studies were attempted at our institution as local technical expertise was unavailable. Following collaboration with a neuroradiologist at an expert centre, images ofsufficient quality for diagnosis were obtained.


OBJECTIVE
The study objective is to evaluate the initial experience with fetal brain MRI and its effects on patient counselling and management in a resource limited healthcare system.


METHODS
In seven fetuses with abnormal ultrasound neuroimaging, fetal MRI was performed with T2-weighted single-shot fast spin-echo (SSFSE) sequences using a 1.5T magnet (GE Medical Systems, Milwaukee, WI).


RESULTS
Magnetic resonance imaging did not alter ultrasound diagnosis in two patients (28%); however it changed the diagnosis in three (43%), provided additional information in one (14%) and changed management in two (28%) patients.


CONCLUSIONS
Magnetic resonance imaging availability further elucidated brain pathology, aided patient counselling, parental decision-making and multidisciplinary management.
Fetal Diagnosis and Therapy Unit, Department of Obstetrics and Gynaecology, The University of the West Indies, Kingston 7, Jamaica. nadinej@cwjamaica.com
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Johnson
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Johnson
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Blaser
D000328:Adult; D001927:Brain Diseases / Q000175:diagnosis*; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis*; D006801:Humans; D007563:Jamaica; D008279:Magnetic Resonance Imaging; D009421:Nervous System Malformations / Q000175:diagnosis*; D011247:Pregnancy; D016216:Ultrasonography, Prenatal; D055815:Young Adult