If fetal brain abnormality is suspected on a pregnancy ultrasound, following this with in-utero MRI (iuMRI) improves diagnostic accuracy. This sequence could allow more informed discussions and decision-making around whether to continue with or terminate a pregnancy.
The NIHR funded study included 565 women of 18 weeks’ pregnancy or more who received ultrasound followed by iuMRI. Diagnoses were confirmed either by postnatal imaging of the baby or at post-mortem examination.
Overall iuMRI gave the correct diagnosis for 93% of scans compared to only 68% of ultrasounds. The accuracy of ultrasound declined above 24 weeks of pregnancy, whereas iuMRI performed well at all times. Clinicians reported that iuMRI scan results caused them to modify their future care planning in over 20% of cases.
Cost effectiveness was not assessed and iuMRI scans are not as widely available as ultrasound. Therefore, resource issues are an important consideration when judging whether or how to implement iuMRI into the diagnostic pathway.
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