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Amniotic fluid volume: Rapid MR-based assessment at 28-32 weeks gestation.

Accepted version
Peer-reviewed

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Type

Article

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Authors

Hilliard, NJ 
Hawkes, R 
Patterson, AJ 
Graves, MJ 
Priest, AN 

Abstract

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: Thirty-five 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 (R(2) = 0.802, p < 0.001). For the US measurements, SDVP measurement related most closely to amniotic fluid volume, (R(2) = 0.470, p < 0.001), with AFI demonstrating a weaker relationship (R(2) = 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. KEY POINTS: • MR projection hydrography can be used to estimate amniotic fluid volume. • MR projection hydrography relies on the T2w signal from amniotic fluid. • Amniotic fluid volume (AFV) is more accurately assessed than with ultrasound.

Description

Keywords

Amniotic Fluid, Comparative Study, Magnetic Resonance Imaging, Pregnancy, Ultrasound, Adult, Amniotic Fluid, Female, Gestational Age, Humans, Magnetic Resonance Imaging, Observer Variation, Pregnancy, Prenatal Diagnosis, Ultrasonography, Prenatal, Young Adult

Journal Title

Eur Radiol

Conference Name

Journal ISSN

0938-7994
1432-1084

Volume Title

Publisher

Springer Science and Business Media LLC
Sponsorship
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.