Anatomical subgroup analysis of the MERIDIAN cohort:: Ventriculomegaly
Anatomical subgroup analysis of the MERIDIAN cohort:: Ventriculomegaly
Objective: To assess the contribution of fetal magnetic resonance imaging (MRI) in fetuses of the MERIDIAN cohort diagnosed with ventriculomegaly (VM) as the only abnormal intracranial finding on antenatal ultrasound.
Methods: This was a subgroup analysis of the MERIDIAN study of fetuses with only VM diagnosed on ultrasound in women who had a subsequent MRI examination within 2 weeks and for whom outcome reference data were available. The diagnostic accuracy of ultrasound and MRI was reported in relation to the severity of VM. The difference in measurements of trigone size on the two imaging methods and the clinical impact of adding MRI to the diagnostic pathway were also studied.
Results: In 306 fetuses with VM, ultrasound failed to detect 31 additional brain abnormalities, having an overall diagnostic accuracy of 89.9% for ultrasound, whilst MRI correctly detected 27 of the additional brain abnormalities, having a diagnostic accuracy of 98.7% (P < 0.0001). There were other brain abnormalities in 14/244 fetuses with mild VM on ultrasound (diagnostic accuracy, 94.3%) and MRI correctly diagnosed 12 of these (diagnostic accuracy, 99.2%; P = 0.0005). There was a close agreement between the size of trigones measured on ultrasound and on MRI, with categorical differences in only 16% of cases, showing that MRI did not systematically overestimate or underestimate trigone size. Complete prognostic data were available in 295/306 fetuses and the prognosis category changed after MRI in 69/295 (23.4%) cases. The overall effect of MRI on clinical management was considered to be ‘significant’, ‘major’ or ‘decisive’ in 76/295 (25.8%) cases.
Conclusion: Our data suggest that a woman carrying a fetus with VM as the only intracranial finding on ultrasound should be offered an adjuvant investigation by MRI for further evaluation.
736-744
Griffiths, P. D.
903ae433-8711-4693-95e0-612a86fed710
Brackley, K.
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Bradburn, M.
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Connolly, D. J. A.
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Gawne-Cain, M. L.
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Griffiths, D. I.
735e61ab-7cae-4965-9c02-68dc2f8ee307
Kilby, M. D.
dc85a6f2-acb0-4a0b-afbc-2aed41cb9ad5
Mandefield, L.
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Mooney, C.
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Robson, S. C.
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Vollmer, B.
044f8b55-ba36-4fb2-8e7e-756ab77653ba
Mason, G.
a3297c38-d36c-4ce7-865a-ebd5ccbf2244
4 December 2017
Griffiths, P. D.
903ae433-8711-4693-95e0-612a86fed710
Brackley, K.
0a4c7155-8300-44cd-b463-c629faafdecf
Bradburn, M.
02085bb8-0d49-4713-8c27-4b6d6c1cdf08
Connolly, D. J. A.
90242ec0-504f-4e22-be64-9d210a9dd0d7
Gawne-Cain, M. L.
965db1c3-79ca-455a-82e0-1cdc9b8042c4
Griffiths, D. I.
735e61ab-7cae-4965-9c02-68dc2f8ee307
Kilby, M. D.
dc85a6f2-acb0-4a0b-afbc-2aed41cb9ad5
Mandefield, L.
50d35200-6d9f-4622-8569-516dcca091c8
Mooney, C.
d2fae4c9-e6c7-45e1-b8fe-4878ca1087a8
Robson, S. C.
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Vollmer, B.
044f8b55-ba36-4fb2-8e7e-756ab77653ba
Mason, G.
a3297c38-d36c-4ce7-865a-ebd5ccbf2244
Griffiths, P. D., Brackley, K., Bradburn, M., Connolly, D. J. A., Gawne-Cain, M. L., Griffiths, D. I., Kilby, M. D., Mandefield, L., Mooney, C., Robson, S. C., Vollmer, B. and Mason, G.
(2017)
Anatomical subgroup analysis of the MERIDIAN cohort:: Ventriculomegaly.
Ultrasound in Obstetrics & Gynecology, 50 (6), .
(doi:10.1002/uog.17475).
Abstract
Objective: To assess the contribution of fetal magnetic resonance imaging (MRI) in fetuses of the MERIDIAN cohort diagnosed with ventriculomegaly (VM) as the only abnormal intracranial finding on antenatal ultrasound.
Methods: This was a subgroup analysis of the MERIDIAN study of fetuses with only VM diagnosed on ultrasound in women who had a subsequent MRI examination within 2 weeks and for whom outcome reference data were available. The diagnostic accuracy of ultrasound and MRI was reported in relation to the severity of VM. The difference in measurements of trigone size on the two imaging methods and the clinical impact of adding MRI to the diagnostic pathway were also studied.
Results: In 306 fetuses with VM, ultrasound failed to detect 31 additional brain abnormalities, having an overall diagnostic accuracy of 89.9% for ultrasound, whilst MRI correctly detected 27 of the additional brain abnormalities, having a diagnostic accuracy of 98.7% (P < 0.0001). There were other brain abnormalities in 14/244 fetuses with mild VM on ultrasound (diagnostic accuracy, 94.3%) and MRI correctly diagnosed 12 of these (diagnostic accuracy, 99.2%; P = 0.0005). There was a close agreement between the size of trigones measured on ultrasound and on MRI, with categorical differences in only 16% of cases, showing that MRI did not systematically overestimate or underestimate trigone size. Complete prognostic data were available in 295/306 fetuses and the prognosis category changed after MRI in 69/295 (23.4%) cases. The overall effect of MRI on clinical management was considered to be ‘significant’, ‘major’ or ‘decisive’ in 76/295 (25.8%) cases.
Conclusion: Our data suggest that a woman carrying a fetus with VM as the only intracranial finding on ultrasound should be offered an adjuvant investigation by MRI for further evaluation.
Text
Griffiths_et_al-2017-Ultrasound_in_Obstetrics_&_Gynecology-1
- Accepted Manuscript
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Accepted/In Press date: 17 March 2017
e-pub ahead of print date: 5 November 2017
Published date: 4 December 2017
Organisations:
Clinical & Experimental Sciences
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Local EPrints ID: 410650
URI: http://eprints.soton.ac.uk/id/eprint/410650
PURE UUID: 371f45a5-7500-46ca-9b93-7e7d7c8cf953
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Date deposited: 09 Jun 2017 09:18
Last modified: 16 Mar 2024 05:18
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Contributors
Author:
P. D. Griffiths
Author:
K. Brackley
Author:
M. Bradburn
Author:
D. J. A. Connolly
Author:
M. L. Gawne-Cain
Author:
D. I. Griffiths
Author:
M. D. Kilby
Author:
L. Mandefield
Author:
C. Mooney
Author:
S. C. Robson
Author:
G. Mason
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