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Magnetic resonance imaging in the normal fetal heart and in congenital heart disease
Author(s) -
Votino C.,
Jani J.,
Damry N.,
Dessy H.,
Kang X.,
Cos T.,
Divano L.,
Foulon W.,
De Mey J.,
Cannie M.
Publication year - 2012
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1002/uog.10061
Subject(s) - medicine , heart disease , fetus , ventricular outflow tract , magnetic resonance imaging , steady state free precession imaging , outflow , cardiology , fetal echocardiography , gestational age , abnormality , ultrasound , radiology , prenatal diagnosis , pregnancy , genetics , physics , psychiatry , meteorology , biology
Objective To evaluate prospectively the feasibility of magnetic resonance imaging (MRI) for assessment of the fetal heart for congenital heart disease (CHD). Methods This was a cross‐sectional study, including 66 fetuses with a normal heart and 40 with CHD. The fetal heart was examined on MRI using axial steady‐state free precession (SSFP) sequences. Regression analysis was used to investigate the effect on the ability to visualize cardiac anatomy of gestational age at examination, maternal body mass index, presence of fetal cardiac abnormality, fetal movements, fetal lie and twinning. The sensitivity and specificity of detecting cardiac defects were calculated. Results The four‐chamber view was visualized in 98.1% of fetuses. The sensitivity of detecting a cardiac defect on the four‐chamber view was 88% and the specificity 96%. The ability to visualize the left and right outflow tracts was only influenced by the presence of fetal movements: for the left outflow tract 94.4 vs. 50.0% visualization and for the right outflow tract 92.6 vs. 53.8% visualization without and with fetal movements, respectively. The sensitivity of detecting a cardiac defect of the left outflow tract was 63% and the specificity 100%, while sensitivity and specificity were 59 and 97%, respectively, for the right outflow tract. Conclusions Despite the use of SSFP sequences, MRI in the fetal heart remains of limited value. It can only be used as a second‐line approach for abnormalities of the four‐chamber view suspected at prenatal ultrasound. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.