Imaging the fetal spine using in utero MR: diagnostic accuracy and impact on management

Background: In-utero MR imaging (iuMR) has entered the clinical arena during the last decade. It is used mainly for imaging fetal brain abnormalities. Objective: To report our experience of imaging the fetal spine and spinal cord in fetuses with known or suspected abnormalities diagnosed on US imaging. Materials and methods: Prospective imaging and retrospective analysis of the possible impact on management of 50 consecutive fetuses with spinal abnormalities detected by antenatal US imaging. Results: In 40 (80%) of 50 fetuses, iuMR and US imaging were in complete agreement. In the other 10 fetuses (20%), iuMR provided additional information or changed the diagnosis, including 8 fetuses where the iuMR could find no abnormality and was found to be correct by later follow-up. Conclusion: IuMR is useful in fetuses with a suspected spinal abnormality. The clinical impact of iuMR may be numerically less than with brain abnormalities, but is still sufficient to warrant its use, especially if there is any uncertainty about the US imaging, and particularly as a relatively high proportion of diagnoses on US imaging are false-positives.