Fetal cardiac cine magnetic resonance imaging in utero

Chaptinel, Jérôme; Yerly, Jérôme; Mivelaz, Yvan; Prša, Milan; Alamo, Leonor; Vial, Yvan; Berchier, Grégoire; Rohner, Chantal; Gudinchet, F.; Stuber, Matthias

doi:10.1038/s41598-017-15701-1

Cited by 40 publications

(37 citation statements)

References 33 publications

(28 reference statements)

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“…The median maternal and gestational age was 32 years [25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] and 30 [24][25][26][27][28][29][30][31][32][33][34][35][36] weeks' gestation, respectively, at the time of MRI.…”

Section: Resultsmentioning

confidence: 99%

“…35,36 MRI is not currently sufficient to diagnose heart defects. 37 Ultrasonography remains the most accurate method for diagnosing conotruncal congenital heart disease, which appears to be the most common structural defect of CHARGE syndrome (96.1%), according to the published literature. 34,38,39 Conotruncal defects appear to be reliably identified in CS, even more so than cranio-encephalic anomalies.…”

Section: Other Mri Findingsmentioning

confidence: 99%

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Fetal MRI findings in a retrospective cohort of 26 cases of prenatally diagnosed CHARGE syndrome individuals

et al. 2019

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“CHARGE syndrome” (CS) is a multifaceted syndrome associated with a poor prognosis. The prenatal diagnosis remains challenging especially as the fetal anomalies that may evoke suspicion of CS are not comprehensively described. Objective This study aims to identify the anomalies in MRI with suspected CHARGE syndrome and to propose a possible standardization in the image‐based prenatal diagnosis of CS. Methods This was a retrospective study of 26 fetuses who underwent MRI and had a confirmed diagnosis of CS, as proven by histopathological and/or neonatal examinations and/or the presence of the CHD7 gene mutation. Results The three most frequent MRI anomalies confirmed at histopathological and/or neonatal examinations were arhinencephaly in 100% (26 of 26), dysplasia of the semicircular canals agenesis (SCA) in 100% (24 of 24), and posterior fossa anomalies in 100% (22 of 22). Our study also revealed short petrous bones with a particular triangular shape in 24 of 24 cases of SCA. Other relevant findings included external ear anomalies in 36% (9 of 25), cleft lip and palate (9 of 9), ventriculomegaly (VMG) (6 of 6), short corpus callosum (3 of 3), and ocular asymmetry in 36.6% (4 of 11). Conclusion Our study emphasizes the interest of fetal MRI in the diagnosis of CS with an adapted knowledge of semiology.

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Section: Resultsmentioning

confidence: 99%

Section: Other Mri Findingsmentioning

confidence: 99%

Fetal MRI findings in a retrospective cohort of 26 cases of prenatally diagnosed CHARGE syndrome individuals

et al. 2019

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“…The self‐gating technique uses specific patterns of the cardiac cycle that are propagated for the following of heart cycles. Only recently, self‐gated dynamic fetal cardiac MRI was performed in six fetuses and comparison with echocardiography demonstrated good agreement in terms of cardiac diameters and area measurements. This method is also dependent on specialized software.…”

Section: Discussionmentioning

confidence: 99%

Dynamic fetal cardiac magnetic resonance imaging in four‐chamber view using Doppler ultrasound gating in normal fetal heart and in congenital heart disease: comparison with fetal echocardiography

Sousa

Hecher

Yamamura

et al. 2019

Ultrasound in Obstet & Gyne

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Objectives To investigate the diagnostic performance of dynamic fetal cardiac magnetic resonance imaging (MRI), using a MR‐compatible Doppler ultrasound (DUS) device for fetal cardiac gating, in differentiating fetuses with congenital heart disease from those with a normal heart, and to compare the technique with fetal echocardiography. Methods This was a prospective study of eight fetuses with a normal heart and four with congenital heart disease (CHD), at a median of 34 (range, 28–36) weeks' gestation. Dynamic fetal cardiac MRI was performed using a DUS device for direct cardiac gating. The four‐chamber view was evaluated according to qualitative findings. Measurements of the length of the left and right ventricles, diameter of the tricuspid and mitral valves, myocardial wall thickness, transverse cardiac diameter and left ventricular planimetry were performed. Fetal echocardiography and postnatal diagnoses were considered the reference standards. Results Direct cardiac gating allowed continuous triggering of the fetal heart, showing high temporal and spatial resolution. Both fetal cardiac MRI and echocardiography in the four‐chamber view detected pathological findings in three of the 12 fetuses. Qualitative evaluation revealed overall consistency between echocardiography and MRI. On both echocardiography and MRI, quantitative measurements revealed significant differences between fetuses with a normal heart and those with CHD with respect to the length of the right (P < 0.01 for both) and left (P < 0.01 for both) ventricles and transverse cardiac diameter (P < 0.05 and P < 0.01, respectively). Tricuspid valve diameter on cardiac MRI was found to be significantly different in healthy fetuses from in those with CHD (P < 0.05). Conclusions For the first time, this study has shown that dynamic fetal cardiac MRI in the four‐chamber view, using external cardiac gating, allows evaluation of cardiac anatomy and diagnosis of congenital heart disease in agreement with fetal echocardiography. Dynamic fetal cardiac MRI may be useful as a second‐line investigation if conditions for fetal echocardiography are unfavorable. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.

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“…Selection is however challenged by limited cardiovascular visualization by ultrasound or in particular diagnoses with a high rate of false positives (Matsui et al, 2008). Self-gated fetal cine cardiovascular magnetic resonance (CMR) imaging has enabled cine CMR for assessing fetal cardiac anatomy and function also in cases where ultrasound is insufficient for diagnosis (Lloyd et al, 2016;Roy et al, 2016;Chaptinel et al, 2017;Haris et al, 2017). One such solution (Haris et al, 2017) based on socalled iterative Golden-angle RAdial Sparse Parallel (iGRASP) MRI (Feng et al, 2014;Wundrak et al, 2016) was applied in the presented case showing how this CMR method can improve diagnostic accuracy and have direct impact on delivery planning.…”

Section: Case Reportmentioning

confidence: 99%

Fetal iGRASP cine CMR assisting in prenatal diagnosis of complicated cardiac malformation with impact on delivery planning

Bhat

Haris

Bidhult

et al. 2019

Clin Physio Funct Imaging

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SummaryLimited visualization of the fetal heart and vessels by fetal ultrasound due to suboptimal fetal position, patient habitus and skeletal calcification may lead to missed diagnosis, overdiagnosis and parental uncertainty. Counselling and delivery planning may in those cases also be tentative. The recent fetal cardiac magnetic resonance (CMR) reconstruction method utilizing tiny golden‐angle iGRASP (iterative Golden‐angle RAdial Sparse Parallel MRI) allows for cine imaging of the fetal heart for use in clinical practice. This case describes an unbalanced common atrioventricular canal where limited ultrasound image quality and visibility of the aortic arch precluded confirming or ruling out presence of a ventricular septal defect. Need of prostaglandins or neonatal intervention was thus uncertain. Cardiovascular magnetic resonance imaging confirmed ultrasound findings and added value by ruling out a significant ventricular septal defect and diagnosing arch hypoplasia. This confirmed the need of patient relocation for delivery at a paediatric cardiothoracic surgery centre and prostaglandins could be initiated before the standard postnatal ultrasound. The applied CMR method can thus improve diagnosis of complicated fetal cardiac malformation and has direct clinical impact.

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Fetal cardiac cine magnetic resonance imaging in utero

Cited by 40 publications

References 33 publications

Fetal MRI findings in a retrospective cohort of 26 cases of prenatally diagnosed CHARGE syndrome individuals

Fetal MRI findings in a retrospective cohort of 26 cases of prenatally diagnosed CHARGE syndrome individuals

Dynamic fetal cardiac magnetic resonance imaging in four‐chamber view using Doppler ultrasound gating in normal fetal heart and in congenital heart disease: comparison with fetal echocardiography

Fetal iGRASP cine CMR assisting in prenatal diagnosis of complicated cardiac malformation with impact on delivery planning

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