Foetal MRI Boosts Brain Anomaly Diagnosis, Prognosis

TOPLINE:

Foetal MRI modified patient management in 38% of pregnancies and provided complementary diagnostic information with a prognostic impact in 27% of assessments, according to a new French study. In brain examinations, MRI revealed additional critical findings in cases of ventriculomegaly and posterior fossa malformations.

METHODOLOGY:

• This retrospective, single-centre analysis included 243 patients who underwent both ultrasound and foetal MRI assessments between 2016 and 2022 at a prenatal diagnostic centre in France.
• The mean maternal age was 29 years, 42% of patients had at least one cardiovascular risk factor, and 21 participants had twin pregnancies.
• Researchers used a 1.5T MRI system covering the whole foetus and additional specialised imaging on the basis of specific indications.
• The primary endpoint was the added diagnostic and prognostic value of MRI, classified as null, complementary without a prognostic impact, complementary with a prognostic impact, and reassignment of diagnosis.

TAKEAWAY:

• Brain MRI examinations (67%) most commonly included isolated ventriculomegaly and midline anomalies as indications. Thoracic investigations (8%) focused on diaphragmatic hernia and bronchopulmonary malformations. Abdominal indications included the characterisation of a mass and complex urinary tract malformations.
• Foetal MRI findings led to the modification of management in 38% of patients and the therapeutic termination of pregnancy in 17% of patients.
• The added diagnostic value of foetal MRI was null in 26% of patients, complementary without a prognostic impact in 36% of patients, complementary with a prognostic impact in 27% of patients, and diagnostic reassignment in 10% of patients.
• MRI provided crucial additional information that modified the prognosis in 80% of posterior fossa anomalies, particularly in cases with open V4 malformations in which MRI led to a detailed assessment of the brain stem and cerebellar hypoplasia.

IN PRACTICE:

“MRI prompted by abnormal brain ultrasound findings has a major impact on the prognosis of a pregnancy, particularly in cases of ventriculomegaly > 10 mm and posterior fossa anomalies with an open V4. In contrast, isolated periventricular cysts and unusual aspects of the cavum pellucidum were not relevant indications. Outside the central nervous system, MRI is of value in the diagnosis of diaphragmatic hernias and complex urinary tract anomalies and for the characterisation of masses,” the authors wrote.

SOURCE:

This study was led by Antoine Delval, MD, Amiens University Hospital, Amiens, France. It was published online on April 16, 2025, in the European Journal of Radiology.

LIMITATIONS:

This study included fewer patients for each MRI indication and diagnosis due to the diversity of disease stages, and its retrospective design prevented tracking follow-up losses. As a result, comparisons with neonatal imaging or long-term outcomes were not possible.

DISCLOSURES:

This study did not receive any specific funding from agencies or organisations in the public, commercial, or not-for-profit sectors. The authors reported having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.