Amniotic fluid volume: Rapid MR-based assessment at 28-32 weeks gestation
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Hilliard, N., Hawkes, R., Patterson, A., Graves, M., Priest, A., Hunter, S., Lees, C., et al. (2016). Amniotic fluid volume: Rapid MR-based assessment at 28-32 weeks gestation. European Radiology https://doi.org/10.1007/s00330-015-4179-0
Objectives: This work evaluates rapid magnetic resonance projection hydrography (PH) based amniotic fluid volume (AFV) estimates against established routine ultrasound single deepest vertical pocket (SDVP) and amniotic fluid index (AFI) measurements, in utero, at 28-32 weeks gestation. Manual multi-section planimetry (MSP) based measurement of AFV is used as a proxy reference standard. Methods: 35 women with a healthy singleton pregnancy (20-41 years) attending routine antenatal ultrasound were recruited. SDVP and AFI were measured using ultrasound, with same day MRI assessing AFV with PH and MSP. The relationships between the respective techniques were assessed using linear regression analysis and Bland-Altman method comparison statistics. Results: When comparing estimated AFV, a highly significant relationship was observed between PH and the reference standard MSP (R2=0.802, p<0.001). For the US measurements, SDVP measurement related most closely to amniotic fluid volume, (R2=0.470, p<0.001), with AFI demonstrating a weaker relationship (R2=0.208, p=0.007). Conclusion: This study shows that rapid MRI based PH measurement is a better predictor of AFV, relating more closely to our proxy standard than established US techniques. Although larger validation studies across a range of gestational ages are required this approach could form part of MR fetal assessment, particularly where poly or oligohydramnios is suspected.
magnetic resonance imaging, ultrasonography, comparative study, pregnancy, amniotic fluid
This study was supported by the National Institute of Health Research, Cambridge Biomedical Research Centre. The authors also acknowledge the support of Addenbrooke’s Charitable Trust and thank the participants for their contribution to the study.
External DOI: https://doi.org/10.1007/s00330-015-4179-0
This record's URL: https://www.repository.cam.ac.uk/handle/1810/253051