ESPN 50th Annual Meeting

ESPN 2017


 
Role of fetal MRI in antenatally detected renal anomalies
TINA THEKKEKKARA 1 ELSPETH WHITBY 2 VINCENT KIRKBRIDE 2

1- SHEFFIELD CHILDRENS NHS FOUNDATION TRUST
2- SHEFFIELD TEACHING HOSPITALS NHS FOUNDATION TRUST
 
Introduction:

Fetal MRI begain to be used as an imaging modality in 1983 and as part of research in Sheffield Teaching Hospitals in 1998. Most papers suggest that fetal MRI is a valuable adjunct or complementatry tool to ultrasound imaging. This is the first known research study from the UK and the only five years duration retrospective review in literature assessing the impact of fetal MRI on antenatally suspected renal anomalies.

 

Material and methods:

This retrospective review was based at the Fetal MRI Department at Royal Hallamshire Hospital, part of the Sheffield Teaching Hospitals NHS Foundation Trust. This study included all referrals for fetal MRI from October 2011 to September 2015. Of the 578 referrals identified, 80 were due to renal concerns. The results of the antenatal USG imaging and fetal MRI were compared with that of the postnatal USG imaging which was considered to be the gold standard in this study.

Results:

Out of the eighty referrals, there were four terminations, three stillbirths, nine neonatal deaths and of the rest of the 64 referrals, outcome data was available for 27 pregnancies. Comparable results between antenatal USG imaging and fetal MRI was found in 26% of the pregnancies. Fetal MRI changed the diagnoses in 31.25% and in another 42.5% provided additional information. In 12.5%, the additional information provided could potentailly have impacted on the outcome of these pregnancies and of these, 90% of the additional information were about non-renal related systems. The positive predicitive value for fetal MRI was 88.9% as compared to 74% for antenatal USG imaging.

Conclusions:

Fetal MRI has therefore made an impact on 44% of the pregnancies that underwent fetal MRI due to renal concerns in the antenatal ultrasound imaging.