Využití prenatálního MR v diagnostice rozštěpových vad obličeje

• Main Author: Bělobrádek, Zdeněk
• Other Authors: Eliáš, Pavel
• Format: Doctoral Thesis
• Language: Czech
• Published: 2013
• Online Access: http://www.nusl.cz/ntk/nusl-322254

Use of the prenatal MRI in the orofacial cleft diagnostics Aim: To evaluate the accuracy and credibility of MRI in the assessment of the fetal facial cleft lip defects severity using interobserver agreement between several specialists. Material and method: Our study consists of 23 MRI examinations of fetuses in gestation age before 24 week with differently severe lip clefts, which was detected by ultrasound as well as other 17 examinations without face anomaly (40 cases in total). Datasets were anonymized and analyzed by 3 radiologists and statistical analysis was performed. According to standardised protocol presence of cleft and degree of severity was evaluated - alveolar ridge involvement, continuation or noncontinuation to the pallate. The examinations were perfomed by Siemens Magnetom Symfony Masestro Class 1,5T with use of array coils. Results: Result of MRI was in 20 cases (87 %) in agreement with clinical findings. We found 3 discrepancies (13 %), mainly due to graphically limited examination caused by fetal movements. The best degree of interpretative agreement was in the evaluation of alveolar ridge involvement - 94 % (generalized kappa 0,894, SE 0,106), for isolated cleft lip it was 90 % (generalized kappa 0,848, SE 0,083) and for defect of palatte 86 % (generalized kappa 0,711, SE...