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Pränataldiagnostik

Anwendung und Stellenwert der fetalen Magnetresonanztomographie

Prenatal diagnostics

Application and importance of fetal magnetic resonance imaging

  • Gynäkologie aktuell
  • Published:
Der Gynäkologe Aims and scope

Zusammenfassung

Hintergrund

Mit der Entwicklung ultraschneller T2-Sequenzen in den 1990er-Jahren hat das MRT zunehmend an Bedeutung bei der pränatalen Diagnostik gewinnen können, obgleich die Sonographie das wichtigste bildgebende Verfahren der Pränataldiagnostik bleibt.

Diskussion

Am häufigsten wird fetale MRT-Diagnostik im Rahmen von ZNS-Anomalien angefordert. Durch den sehr guten Weichteilkontrast lassen sich prognoserelevante Zusatzinformationen gewinnen. Dies gilt v. a. für sonographisch schwieriger darzustellenden Regionen wie die Fossa posterior oder neuronale Migrationsstörungen. Mit einem differenzierten Schallbefund und konkreter Fragestellung an das fetale MRT wird die Indikation in der Regel durch einen Pränataldiagnostiker (DEGUM II/ III) gestellt. Ein aussagekräftiges fetales MRT gelingt nur in enger Kooperation zwischen Pränataldiagnostiker und Radiologen.

Fazit

Aufgrund der eher geringen Fallzahl sind der Aufbau von Referenzzentren und Etablierung von Qualitätsstandards analog der publizierten Qualitätsanforderungen an die weiterführende differenzierte Ultraschalluntersuchung in der pränatalen Diagnostik wünschenswert.

Abstract

Background

With the implementation of ultrafast T2-sequences during the 1990s, magnetic resonance imaging (MRI) became more important for prenatal diagnosis, even though ultrasound remains the most important examination technique in fetal imaging.

Discussion

The most commonly requested reason to perform fetal MRI today is for malformations of the central nervous system (CNS). Mainly because of the good tissue contrast, MRI can depict additional information which may be important for estimating fetal prognosis, especially in areas such as the posterior fossa as MR image quality is not impaired by calcification of fetal bones. Usually a specialist in fetal ultrasound will recommend fetal MRI after a detailed ultrasound examination. A clear and helpful result from fetal MRI can only be expected when there is close cooperation between the radiologist and the specialist for fetal ultrasound.

Conclusion

Because of the small number of cases it would be of great benefit to have specialized centers and established standards for quality analogue to the published quality standards for differentiated ultrasound examinations in prenatal diagnostics.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. F. Voigt, C. Loberg, C. Kuhl, N. Maass und T.W. Goecke geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Klinik für Gynäkologie und Geburtsmedizin, Universitätsklinikum der RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland

    F. Voigt, N. Maass & T.W. Goecke

  2. Klinik für diagnostische und interventionelle Radiologie, Universitätsklinikum der RWTH Aachen, Aachen, Deutschland

    C. Loberg & C. Kuhl

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  1. F. Voigt
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  2. C. Loberg
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  3. C. Kuhl
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  4. N. Maass
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  5. T.W. Goecke
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Correspondence to F. Voigt.

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Voigt, F., Loberg, C., Kuhl, C. et al. Pränataldiagnostik. Gynäkologe 47, 680–687 (2014). https://doi.org/10.1007/s00129-014-3404-2

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  • DOI: https://doi.org/10.1007/s00129-014-3404-2

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