Dataset Information

Diagnostic accuracy of ultrasonography and magnetic resonance imaging for the detection of fetal anomalies: a blinded case-control study.

ABSTRACT: OBJECTIVES:To compare the accuracy of two-dimensional ultrasound (2D-US), three-dimensional ultrasound (3D-US) and magnetic resonance imaging (MRI) for the diagnosis of congenital anomalies without prior knowledge of indications and previous imaging findings. METHODS:This was a prospective, blinded case-control study comprising women with a singleton pregnancy with fetal congenital abnormalities identified on clinical ultrasound and those with an uncomplicated pregnancy. All women volunteered to undergo 2D-US, 3D-US and MRI, which were performed at one institution. Different examiners at a collaborating institution performed image interpretation. Sensitivity and specificity of the three imaging methods were calculated for individual anomalies, based on postnatal imaging and/or autopsy as the definitive diagnosis. Diagnostic confidence was graded on a four-point Likert scale. RESULTS:A total of 157 singleton pregnancies were enrolled, however nine cases were excluded owing to incomplete outcome, resulting in 148 fetuses (58 cases and 90 controls) included in the final analysis. Among cases, 13 (22.4%) had central nervous system (CNS) anomalies, 40 (69.0%) had non-CNS anomalies and five (8.6%) had both CNS and non-CNS anomalies. The main findings were: (1) MRI was more sensitive than 3D-US for diagnosing CNS anomalies (MRI, 88.9% (16/18) vs 3D-US, 66.7% (12/18) vs 2D-US, 72.2% (13/18); McNemar's test for MRI vs 3D-US: P?=?0.046); (2) MRI provided additional information affecting prognosis and/or counseling in 22.2% (4/18) of fetuses with CNS anomalies; (3) 2D-US, 3D-US and MRI had similar sensitivity for diagnosing non-CNS anomalies; (4) specificity for all anomalies was highest for 3D-US (MRI, 85.6% (77/90) vs 3D-US, 94.4% (85/90) vs 2D-US, 92.2% (83/90); McNemar's test for MRI vs 3D-US: P?=?0.03); and (5) the confidence of MRI for ruling out certain CNS abnormalities (usually questionable for cortical dysplasias or hemorrhage) that were not confirmed after delivery was lower than it was for 2D-US and 3D-US. CONCLUSIONS:MRI was more sensitive than ultrasonography and provided additional information that changed prognosis, counseling or management in 22.2% of fetuses with CNS anomalies. False-positive diagnoses for subtle CNS findings were higher with MRI than with ultrasonography. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.

SUBMITTER: Goncalves LF

PROVIDER: S-EPMC5987216 | biostudies-literature | 2016 Aug

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Diagnostic accuracy of ultrasonography and magnetic resonance imaging for the detection of fetal anomalies: a blinded case-control study.

Gonçalves L F LF Lee W W Mody S S Shetty A A Sangi-Haghpeykar H H Romero R R

Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology 20160710 2

<h4>Objectives</h4>To compare the accuracy of two-dimensional ultrasound (2D-US), three-dimensional ultrasound (3D-US) and magnetic resonance imaging (MRI) for the diagnosis of congenital anomalies without prior knowledge of indications and previous imaging findings.<h4>Methods</h4>This was a prospective, blinded case-control study comprising women with a singleton pregnancy with fetal congenital abnormalities identified on clinical ultrasound and those with an uncomplicated pregnancy. All women ...[more]

PMID: 26444861

Similar Datasets

Project description:ObjectiveCT serves as gold standard for the evaluation of pulmonary nodules. However, CT exposes patients to ionizing radiation, a concern especially in screening scenarios with repeated examinations. Due to recent technological advances, MRI emerges as a potential alternative for lung imaging using 3D steady state free precession and ultra-short echo-time sequences. Therefore, in this study we assessed the performance of three state-of-the-art MRI sequences for the evaluation of pulmonary nodules.MethodsLesions of variable sizes were simulated in porcine lungs placed in a dedicated chest phantom mimicking a human thorax, followed by CT and MRI examinations. Two blinded readers evaluated the acquired MR-images locating and measuring every suspect lesion. Using the CT-images as reference, logistic regression was performed to investigate the sensitivity of the tested MRI-sequences for the detection of pulmonary nodules.ResultsFor nodules with a diameter of 6 mm, all three sequences achieved high sensitivity values above 0.91. However, the sensitivity dropped for smaller nodules, yielding an average of 0.83 for lesions with 4 mm in diameter and less than 0.69 for lesions with 2 mm in diameter. The positive predictive values ranged between 0.91 and 0.96, indicating a low amount of false positive findings. Furthermore, the size measurements done on the MR-images were subject to a bias ranging from 0.83 mm to -1.77 mm with standard deviations ranging from 1.40 mm to 2.11 mm. There was no statistically significant difference between the three tested sequences.ConclusionWhile showing promising sensitivity values for lesions larger than 4 mm, MRI appears to be not yet suited for lung cancer screening. Nonetheless, the three tested MRI sequences yielded high positive predictive values and accurate size measurements; therefore, MRI could potentially figure as imaging method of the chest in selected follow-up scenarios, e.g. of incidental findings subject to the Fleischner Criteria.

Dataset Information

Diagnostic accuracy of ultrasonography and magnetic resonance imaging for the detection of fetal anomalies: a blinded case-control study.

Publications

Diagnostic accuracy of ultrasonography and magnetic resonance imaging for the detection of fetal anomalies: a blinded case-control study.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets