{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T20:36:33Z","timestamp":1785270993697,"version":"3.55.0"},"reference-count":12,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2017,11,8]],"date-time":"2017-11-08T00:00:00Z","timestamp":1510099200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"National Institute for Health Research Health Technology Assessment Programme","award":["09\/06\/01"],"award-info":[{"award-number":["09\/06\/01"]}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2017,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess the diagnostic and clinical contribution of fetal magnetic resonance imaging (MRI) in fetuses of the MERIDIAN cohort diagnosed with abnormalities of the posterior fossa as the only intracranial abnormality recognized on antenatal ultrasound.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a subgroup analysis of the MERIDIAN study of fetuses with abnormalities of the posterior fossa (with or without ventriculomegaly) diagnosed on antenatal ultrasound in women who had MRI within 2\u2009weeks of ultrasound and for whom outcome reference data were available. The diagnostic accuracy of ultrasound and MRI is reported, as well as indicators of diagnostic confidence and effects on prognosis and clinical management. Appropriate diagnostic confidence was assessed by the score\u2010based weighted average method, which combines diagnostic accuracy with diagnostic confidence data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Abnormalities confined to the posterior fossa according to ultrasound were found in 81 fetuses (67 with parenchymal and 14 with cerebrospinal fluid\u2010containing lesions). The overall diagnostic accuracy for detecting an isolated posterior fossa abnormality was 65.4% for ultrasound and 87.7% for MRI (difference, 22.3% (95% CI, 14.0\u201330.5%); <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001). There was an improvement in \u2018appropriate\u2019 diagnostic confidence, as assessed by the score\u2010based weighted average method (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001), and a three\u2010fold reduction in \u2018high confidence but incorrect diagnosis\u2019 was achieved using MRI. Prognostic information given to the women changed after MRI in 44% of cases, and the overall effect of MRI on clinical management was considered to be \u2018significant\u2019, \u2018major\u2019 or \u2018decisive\u2019 in 35% of cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our data suggest that any woman whose fetus has a posterior fossa abnormality as the only intracranial finding on ultrasound should have MRI for further evaluation. This is on the basis of improved diagnostic accuracy and confidence, which impacts substantially on the prognostic information given to women as well as their clinical management. Copyright \u00a9 2017 ISUOG. Published by John Wiley &amp; Sons Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.17485","type":"journal-article","created":{"date-parts":[[2017,4,11]],"date-time":"2017-04-11T08:26:41Z","timestamp":1491899201000},"page":"745-752","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Anatomical subgroup analysis of the MERIDIAN cohort: posterior fossa abnormalities"],"prefix":"10.1002","volume":"50","author":[{"given":"P. D.","family":"Griffiths","sequence":"first","affiliation":[{"name":"Academic Unit of Radiology, University of Sheffield and INSIGNEO Institute for in silico Medicine University of Sheffield  Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Brackley","sequence":"additional","affiliation":[{"name":"University Hospital Southampton NHS Foundation Trust  Southampton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Bradburn","sequence":"additional","affiliation":[{"name":"Clinical Trials Research Unit, School of Health and Related Research University of Sheffield  Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. J. A.","family":"Connolly","sequence":"additional","affiliation":[{"name":"Department of Radiology, Sheffield Children's Hospital and the Royal Hallamshire Hospital Sheffield Teaching Hospitals NHS Foundation Trust  Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. L.","family":"Gawne\u2010Cain","sequence":"additional","affiliation":[{"name":"University Hospital Southampton NHS Foundation Trust  Southampton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. D.","family":"Kilby","sequence":"additional","affiliation":[{"name":"Centre for Women's &amp; Newborn Health, Institute of Metabolism &amp; Systems Research, University of Birmingham and Fetal Medicine Centre Birmingham Women's Foundation Trust (Birmingham Health Partners)  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Mandefield","sequence":"additional","affiliation":[{"name":"Clinical Trials Research Unit, School of Health and Related Research University of Sheffield  Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3086-7348","authenticated-orcid":false,"given":"C.","family":"Mooney","sequence":"additional","affiliation":[{"name":"Clinical Trials Research Unit, School of Health and Related Research University of Sheffield  Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. C.","family":"Robson","sequence":"additional","affiliation":[{"name":"Newcastle University  Newcastle upon Tyne UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Vollmer","sequence":"additional","affiliation":[{"name":"Clinical and Experimental Sciences University of Southampton and Southampton Children's Hospital University Hospital Southampton NHS Foundation Trust  Southampton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Mason","sequence":"additional","affiliation":[{"name":"Leeds Teaching Hospitals NHS Trust  Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,11,8]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.17475"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.17502"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)31723-8"},{"key":"e_1_2_6_5_1","first-page":"1","article-title":"technique for the measurement of attitudes","volume":"22","author":"Likert R. 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