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An exploration of the potential utility of fetal cardiovascular MRI as an adjunct to fetal echocardiography
Author(s) -
Lloyd David F. A.,
Amerom Joshua F. P.,
Pushparajah Kuberan,
Simpson John M.,
Zidere Vita,
Miller Owen,
Sharland Gurleen,
Allsop Joanna,
Fox Matthew,
Lohezic Maelene,
Murgasova Maria,
Malamateniou Christina,
Hajnal Jo V.,
Rutherford Mary,
Razavi Reza
Publication year - 2016
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.4912
Subject(s) - medicine , fetal echocardiography , magnetic resonance imaging , intracardiac injection , radiology , fetus , steady state free precession imaging , cardiac magnetic resonance imaging , prenatal diagnosis , cardiology , pregnancy , genetics , biology
Objectives Fetal cardiovascular magnetic resonance imaging (MRI) offers a potential alternative to echocardiography, although in practice, its use has been limited. We sought to explore the need for additional imaging in a tertiary fetal cardiology unit and the usefulness of standard MRI sequences. Methods Cases where the diagnosis was not fully resolved using echocardiography were referred for MRI. Following a three‐plane localiser, fetal movement was assessed with a balanced steady‐state free precession (bSSFP) cine. Single‐shot fast spin echo and bSSFP sequences were used for diagnostic imaging. Results Twenty‐two fetal cardiac MRIs were performed over 12 months, at mean gestation of 32 weeks (26–38 weeks). The majority of referrals were for suspected vascular abnormalities (17/22), particularly involving the aortic arch ( n = 10) and pulmonary vessels ( n = 4). Single‐shot fast spin echo sequences produced ‘black‐blood’ images, useful for examining the extracardiac vasculature in these cases. BSSFP sequences were more useful for intracardiac structures. Real‐time SSFP allowed for dynamic assessment of structures such as cardiac masses, with enhancement patterns also allowing for tissue characterisation in these cases. Conclusions Fetal vascular abnormalities such as coarctation can be difficult to diagnose by using ultrasound. Fetal MRI may have an adjunctive role in the evaluation of the extracardiac vascular anatomy and tissue characterisation. © 2016 The Authors. Prenatal Diagnosis published by John Wiley & Sons, Ltd.