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An exploration of the potential utility of fetal cardiovascular MRI as an adjunct to fetal echocardiography

An exploration of the potential utility of fetal cardiovascular MRI as an adjunct to fetal echocardiography

Lloyd, David F.A., Van 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 and Razavi, Reza (2016) An exploration of the potential utility of fetal cardiovascular MRI as an adjunct to fetal echocardiography. Prenatal Diagnosis, 36 (10). pp. 916-925. ISSN 0197-3851 (Print), 1097-0223 (Online) (doi:https://doi.org/10.1002/pd.4912)

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Abstract

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.

Item Type: Article
Additional Information: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Uncontrolled Keywords: Fetal MRI; Optimisation; Cardiac abnormalities; Antenatal screening
Faculty / Department / Research Group: Faculty of Education & Health
Faculty of Education & Health > Department of Family Care & Mental Health
Faculty of Education & Health > Health & Society Research Group
Last Modified: 15 Jan 2018 17:05
Selected for GREAT 2016: None
Selected for GREAT 2017: GREAT b
Selected for GREAT 2018: None
Selected for GREAT 2019: None
URI: http://gala.gre.ac.uk/id/eprint/15991

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