The role of magnetic resonance imaging and urtrasound diagnosis of fetal growth restriction in combination with pathological changes in fetal brain
- Authors: Kulabukhova P.V.1, Bychenko V.G.1, Shmakov R.G.2
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Affiliations:
- Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia
- Moscow Regional Research Institute of Obstetrics and Gynecology named after Academician V.I. Krasnopolsky
- Issue: No 4 (2024)
- Pages: 51-58
- Section: Original Articles
- URL: https://journals.eco-vector.com/0300-9092/article/view/632082
- DOI: https://doi.org/10.18565/aig.2023.55
- ID: 632082
Cite item
Abstract
Background: Fetal growth restriction (FGR) is a common complication of pregnancy and, in severe cases, leads to increased perinatal mortality, neonatal morbidity, and poor prognosis for life expectancy in patients with congenital malformations of the central nervous system and hypoxic-ischemic changes in the brain. Early detection of brain injury in IUGR enables to predict short-term and long-term outcomes for the development of the central nervous system, that currently remains a serious issue.
Objective: The aim of the study was to assess the role of ultrasound and MRI in diagnosis of FGR in combination with pathological changes in fetal brain.
Materials and methods: The retrospective study included 24 patients with suspected FGR. The mean age of patients (Me; Q1–Q3) was 33 (25–41) years, the average pregnancy length was 27.5 (20–35) weeks. The patients underwent simultaneous diagnostic US and MRI of the fetuses in the second and third trimester of pregnancy to assess fetal head circumference using percentile values of nomograms, and identify comorbidity, including the changes in fetal brain.
Results: No false positive results were found. MRI data and US imaging data were absolutely similar in nomograms for measurement of fetal brain volume using percentile method in 24 fetuses (100%) with FGR. Among them, FGR in combination with congenital diaphragmatic hernia was diagnosed in 3 fetuses (12.5%), and spina bifida in 1 fetus (4.2%). Comparison of two imaging techniques showed that false-negative results of ultrasound detection of malformation of the cortical plate and assessment of sulcation of the fetal brain were found in 3 fetuses (12.5%) versus 7 fetuses (29.2%) using MRI. Also, ultrasound imaging in diagnosing isolated unilateral cerebellar hypoplasia, showed false negative results in 2 fetuses (8.3%) versus false negative MRIs in 5 fetuses (20.9%).
Conclusion: The study showed that diagnostic ultrasound and MRI are comparable techniques in assessing biometry of the fetal brain using centile nomograms. However, MRI helps to perform more careful assessment of the concomitant pathology of the fetal brain.
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About the authors
Polina V. Kulabukhova
Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia
Author for correspondence.
Email: kulpola@mail.ru
ORCID iD: 0000-0002-0363-3669
Radiologist, Radiology Department
Russian Federation, MoscowVladimir G. Bychenko
Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia
Email: v_bychenko@oparina4.ru
ORCID iD: 0000-0002-1459-4124
PhD, Radiologist, Head of the Department of Radiation Diagnostics
Russian Federation, MoscowRoman G. Shmakov
Moscow Regional Research Institute of Obstetrics and Gynecology named after Academician V.I. Krasnopolsky
Email: kulpola@mail.ru
ORCID iD: 0000-0002-2206-1002
Dr. Med. Sci., Professor of the RAS, Non-staff Chief Specialist in Obstetrics at Ministry of Health of Russia; Director of GBUZ MO MONIIAG
Russian Federation, MoscowReferences
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