Fetal MRI diagnosis of 2 types of left pulmonary artery sling

Li, Xuelei; Xu, Li; Saul, David; Zhao, Zhen

doi:10.1016/j.radcr.2017.07.013

Cited by 8 publications

(11 citation statements)

References 7 publications

(9 reference statements)

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“…The prenatal features of 4 additional cases have been described retrospectively after a postnatal diagnosis of LPAS was made by MRI or CT imaging. 3,[5][6][7][8] Only three out of thirteen cases are isolated and have no cardiac and extra cardiac findings on fetal echocardiography examination. 3,[5][6][7][8] Only three out of thirteen cases are isolated and have no cardiac and extra cardiac findings on fetal echocardiography examination.…”

Section: Discussion and Con Clus I Onmentioning

confidence: 99%

“…[6][7][8] In these previously reported cases, 7 out of 13 (% 54) had an abnormal cardiac axis, position, and/or echogenic lungs which resulted in further imaging before and after birth. 3,4,10 In 4 out of 13 cases (% 30), structural heart diseases have been reported. 3,4,10 In 4 out of 13 cases (% 30), structural heart diseases have been reported.…”

Section: Discussion and Con Clus I Onmentioning

confidence: 99%

“…To date, there are a few case reports of prenatal diagnosis of LPAS in the literature [3][4][5][6][7][8][9][10] (Table 1). The prenatal features of 4 additional cases have been described retrospectively after a postnatal diagnosis of LPAS was made by MRI or CT imaging.…”

Section: Discussion and Con Clus I Onmentioning

confidence: 99%

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Prenatal diagnosis of left pulmonary artery sling and review of literature

et al. 2019

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Left pulmonary artery sling (LPAS) is a very rare cause of large airway compression. In LPAS, the left pulmonary artery (LPA) arises from the proximal right pulmonary artery, coursing over the right mainstem bronchus, posterior to the trachea and anterior to the esophagus prior to reaching the left hilum. The aberrant course of the LPA results in anatomical obstruction of the right mainstem bronchus, the trachea, or both. Thirty percent of affected patients have major associated structural heart disease 1 which can importantly impact clinical outcome. 2 The clinical manifestation of LPAS after birth usually relates to the severity of airway obstruction and the associated cardiac pathology. Only a few reports present the prenatal features of LPAS. In the present report, we present the prenatal diagnosis of a case of LPAS in one of a set of identical twins in which the only feature was that of an abnormal course of the LPA on 3-vessel tracheal view. | C A S E PRE S ENTATI ONA 30-year-old primigravida woman at 27 weeks' gestation was referred to our maternal fetal medicine unit given the presence of a set of monochorionic, diamniotic spontaneous twins. A full anatomical ultrasound examination performed in both fetuses demonstrated no pathology, and fetal echocardiography demonstrated no major structural heart disease in one twin. In the other twin, fetal echocardiography revealed on a 3-vessel tracheal view that the LPA originated from the right pulmonary artery, originating initially to the right side of the trachea, and turning sharply to course between the trachea and esophagus prior to joining the left hilum (Figure 1, Movie S1). The examination was performed transabdominally using a Voluson E 6 (GE healthcare Ultrasound, Milwaukee, WI, USA) ultrasound machine equipped with a RAB 6D (2-7 MHz) probe. With these findings, pediatric cardiology counseling was offered and LPAS was suspected. The remainder of the cardiac anatomy was Left pulmonary artery sling (LPAS) is a very rare cause of large airway compression.In LPAS, the left pulmonary artery (LPA) arises from the proximal right pulmonary artery, coursing over the right mainstem bronchus, posterior to the trachea and anterior to the esophagus prior to reaching the left hilum. The aberrant course of the LPA results in anatomical obstruction of the right mainstem bronchus, the trachea, or both. Only a few reports present the prenatal features of LPAS. In this report, we present the prenatal diagnosis of a case of LPAS in one of a set of identical twins in which the only feature was that of an abnormal course of the LPA on 3-vessel tracheal view. The cross-sectional view at the level of three vessels which includes both pulmonary artery branches is useful to detect this abnormality. Color and power Doppler may be helpful as well. K E Y W O R D Sfetal echocardiography, left pulmonary artery, vascular imaging

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Section: Discussion and Con Clus I Onmentioning

confidence: 99%

Section: Discussion and Con Clus I Onmentioning

confidence: 99%

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Prenatal diagnosis of left pulmonary artery sling and review of literature

et al. 2019

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“…The diagnostic role of fetal MRI, as a complementary second level tool useful when the ultrasound is hampered by inadequate acoustic window, has recently been proposed by several groups. 9,[38][39][40][41][42] In a prospective single-center study, a combination of SSFP and SS-T 2 -TSE sequences identified the same diagnosis as postnatal findings in 79% of fetuses with CHD at a mean gestational age of 25.5 weeks. 38 In that study the diagnostic sensitivity for cardiac anomalies by ultrasound screening performed by an obstetrician and by a fetal cardiac specialist were 46% and 82%, respectively.…”

Section: Complementary Diagnostic Role Of Fetal Cardiac Mrimentioning

confidence: 95%

“…However, it may be limited by fetal position, oligohydramnios, overlying bone, and obesity. The diagnostic role of fetal MRI, as a complementary second level tool useful when the ultrasound is hampered by inadequate acoustic window, has recently been proposed by several groups . In a prospective single‐center study, a combination of SSFP and SS‐T 2 ‐TSE sequences identified the same diagnosis as postnatal findings in 79% of fetuses with CHD at a mean gestational age of 25.5 weeks .…”

Section: Complementary Diagnostic Role Of Fetal Cardiac Mrimentioning

confidence: 99%

MR imaging of the fetal heart

Marini

Amerom

Saini

et al. 2019

Magnetic Resonance Imaging

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In the last decade, technological advances have enabled the acquisition of high spatial and temporal resolution cardiac magnetic resonance imaging (MRI) in the fetus. Fetal cardiac MRI has emerged as an alternative to ultrasound, which may be helpful to confirm a diagnosis of congenital heart disease when ultrasound assessment is hampered, for example in late gestation or in the setting of oligohydramnios. MRI also provides unique physiologic information, including vessel blood flow, oxygen saturation and hematocrit, which may be helpful to investigate cardiac and placental diseases. In this review, we summarize some of the main techniques and significant advances in the field to date. Level of Evidence: 5 Technical Efficacy: Stage 5 J. Magn. Reson. Imaging 2020;51:1030–1044.

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Current and future role of fetal cardiovascular MRI in the setting of fetal cardiac interventions

Marini

Sun

et al. 2019

Prenatal Diagnosis

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Over recent years, technical developments resulting in the feasibility of fetal cardiovascular magnetic resonance (CMR) have provided a new diagnostic tool for studying the human fetal heart and circulation. During the same period, we have witnessed the arrival of several minimally invasive fetal cardiac interventions (FCI) as a possible form of treatment in selected congenital heart diseases (CHDs). The role of fetal CMR in the planning and monitoring of FCI is not yet clear. Indeed, high-quality fetal CMR is not available or routinely offered at most centers caring for patients with prenatally detected CHD. However, in theory, fetal CMR could have much to offer in the setting of FCI by providing complementary anatomic and physiologic information relating to the specific intervention under consideration. Similarly, fetal CMR may be useful as an alternative imaging modality when ultrasound is hampered by technical limitations, for example, in the setting of oligohydramnios and in late gestation. In this review, we summarize current experience of the use of fetal CMR in the diagnosis and monitoring of fetuses with cardiopathies in the setting of a range of invasive in utero cardiac and vascular interventions and medical treatments and speculate about future directions for this versatile imaging medium.

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Fetal MRI diagnosis of 2 types of left pulmonary artery sling

Cited by 8 publications

References 7 publications

Prenatal diagnosis of left pulmonary artery sling and review of literature

Prenatal diagnosis of left pulmonary artery sling and review of literature

MR imaging of the fetal heart

Current and future role of fetal cardiovascular MRI in the setting of fetal cardiac interventions

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