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Magnetic Resonance Imaging: A New Tool to Optimize the Prediction of Fetal Anemia?

2019; Karger Publishers; Volume: 46; Issue: 4 Linguagem: Inglês

10.1159/000494615

1421-9964

Ditte Staub Jørgensen, Niels Vejlstrup, Line Rode, C. K. Ekelund, Christopher K. Macgowan, Lisa Neerup Jensen, Lone Nikoline Nørgaard, Sharon Portnoy, Mike Seed, Karin Sundberg, Kirsten Søgaard, Julie Lyng Forman, Ann Tabor,

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<b><i>Introduction:</i></b> The false-positive rate in the prediction of fetal anemia is 10–15%. We investigated if a new, noninvasive MRI method used as a supplement to ultrasound could improve the prediction. <b><i>Methods:</i></b> Fetuses suspected of anemia and controls were scanned in a 1.5-tesla MRI scanner 1–4 times during pregnancy. Cases were scanned before and after intrauterine blood transfusion with a T1-mapping MRI sequence in a cross-section of the umbilical vein. <b><i>Results:</i></b> Inclusion of 8 cases and 11 controls resulted in 10 case scans (2 cases were included twice) and 33 control scans. In controls, the T1 relaxation time was 1,005–1,391 ms; in cases with severe anemia, 1,505–1,595 ms, moderate anemia 1,503–1,525 ms, and no/mild anemia 1,245–1,410 ms. After blood transfusions, values dropped to 1,123–1,288 ms. The mean value in moderate and severe anemic cases was 275 ms higher than in controls (95% CI 210–341 ms, <i>p</i> &#x3c; 0.0001), and after blood transfusion it was comparable to controls (3 ms, 95% CI –62 to 68 ms, <i>p</i> = 0.934). A 1,450-ms cut-off would have identified all cases in need of blood transfusion with no false-positive cases. <b><i>Conclusions:</i></b> Our findings indicate a potential for this new MRI method to improve the prediction of fetal anemia as a supplement to ultrasound.