MR imaging of the fetal heart

Marini, Davide; Amerom, Joshua F.P. van; Saini, Brahmdeep S.; Sun, Liqun; Seed, Mike

doi:10.1002/jmri.26815

Cited by 18 publications

(16 citation statements)

References 88 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…All rights reserved. (Marini & Amerom, 2019). Several non-invasive approaches for overcoming the absence of the ECG have been investigated in sheep and humans including self-gating, cardiotocography (CTG)/doppler ultrasound gating (DUS), and retrospective image reconstruction techniques such as metric optimized gating (MOG) (Yamamura et al, 2011(Yamamura et al, , 2012Roy et al, 2013;Lloyd et al, 2016;Chaptinel et al, 2017;Haris et al, 2017;Kording et al, 2018;Lloyd et al, 2019).…”

Section: Discussionmentioning

confidence: 99%

“…Although VV by CMR has been reported to have excellent accuracy and reproducibility in human adults and children, its application in the setting of fetal CMR is complicated by the small size of the structures of interest, high heart rate, technical challenges with image acquisition including the absence of the usual electrocardiographic trigger for acquiring images synchronized to the cardiac cycle, and the fetus' propensity for frequent vigorous body movements (Buechel et al, 2009;Roy et al, 2013Roy et al, , 2017Marini & Amerom, 2019;Toemen et al, 2019). Many of these challenges appear to be surmountable, particularly when CMR is applied in fetal sheep (Yamamura et al, 2009(Yamamura et al, , 2011(Yamamura et al, , 2012Duan et al, 2017Duan et al, , 2019Schrauben et al, 2019), which is an excellent model of the human fetal cardiovascular system owing to similarities between the species in terms of fetal size and cardiovascular anatomy and physiology, as well as the ability to withstand fetal instrumentation for extended periods (Botting et al, 2012;Brain et al, 2015;Lock et al, 2018;Morrison et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Feasibility of ventricular volumetry by cardiovascular MRI to assess cardiac function in the fetal sheep

Cho

Darby

Saini

et al. 2020

The Journal of Physiology

Self Cite

View full text Add to dashboard Cite

The application of fetal cardiovascular magnetic resonance imaging (CMR) to assess fetal cardiovascular physiology and cardiac function through the quantification of ventricular volumes has previously been investigated, but the approach has not yet been fully validated. Ventricular output measurements calculated from heart rate and stroke volumes (SV) of the right and left ventricles measured by ventricular volumetry (VV) exhibited a high level of agreement with phase-contrast (PC) blood flow measurements in the main pulmonary artery and ascending aorta, respectively. Ejection fraction of the right ventricle, which is lower than that of the left ventricle in postnatal subjects, was similar to the left ventricular ejection fraction in the fetus; likely due to the different loading conditions present in the fetal circulation. This study provides evidence to support the reliability of VV in the sheep fetus, providing evidence for its use in animal models of human diseases affecting the fetal circulation.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Feasibility of ventricular volumetry by cardiovascular MRI to assess cardiac function in the fetal sheep

Cho

Darby

Saini

et al. 2020

The Journal of Physiology

Self Cite

View full text Add to dashboard Cite

show abstract

“…SS‐T2W‐TSE sequences with half Fourier reconstruction provide a high‐resolution image within 2 seconds, yielding excellent contrast between the vessels, which appear black because of the loss of any signal from flowing blood and surrounding structures such as the lungs, which are bright . Improved visualization of extracardiac vessels in fetuses with CHD has recently been reported in a large prospective, single‐center cohort study using three‐dimensional reconstructions of SS‐T2W‐TSE acquisitions …”

Section: Diagnostic Role Of Fetal Cardiovascular Mrimentioning

confidence: 99%

“…A “bright blood” sequence is the best option for achieving images that depict both the intracardiac and extracardiac anatomy, and SSFP sequences are ideal as they provide excellent contrast between the blood pool and myocardium and have a very short acquisition time. SSFP can be used to obtain single shot static images with a scan time of approximately 1 second per slice or triggered cine images of the beating heart (Videos S1‐S3). Comparisons of cine SSFP with echocardiography indicate that although more anatomic features are usually identified with echocardiography, the combination of information provided by both modalities enabled identification of additional anatomic features in fetuses with CHD .…”

Section: Diagnostic Role Of Fetal Cardiovascular Mrimentioning

confidence: 99%

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

Marini

Sun

et al. 2019

Prenatal Diagnosis

Self Cite

View full text Add to dashboard Cite

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.

show abstract

“…Pulse-wave Doppler does not resolve flow-induced vortices and cannot measure energy losses or pressure distributions. Advancements in 4D MRI are improving the capabilities of fetal heart assessment (10), but flow imaging has only been studied in animals to date (11). Significant motion, lack of ECG gating, and low image resolution similarly affect 4D MRI imaging.…”

Section: Introductionmentioning

confidence: 99%

Fetal and Neonatal Echocardiographic Analysis of Biomechanical Alterations for the Hypoplastic Left Heart

Meyers¹,

Brindise²,

Payne

et al. 2020

Preprint

View full text Add to dashboard Cite

Objectives To show simultaneous quantification of flow and mechanics of cardiac function from fetal and neonatal echocardiograms using an integrated set of automated, physics-based, echocardiography analysis methods. Background Quantifying ventricular biomechanics from fetal and neonatal echocardiograms presents unique and significant challenges. Existing analysis tools are designed for adults and cannot accurately assess fetal subjects. Methods We used in-house developed analysis algorithms to quantify ventricular biomechanics from four-chamber B-mode and color Doppler routine examinations recordings for three hypoplastic left heart (HLHS) patients at 33-weeks' gestation and first week post-birth along with age-matched controls. Chamber morphology, tissue motion, atrioventricular valve inflow, global longitudinal strain, and hemodynamic flow parameters were measured. Results Prenatal cardiac output differed between control (LV:157±139 mL/min, RV:257±218 mL/min) and HLHS subjects (410±128 mL/min). This difference persisted for control (LV:233±74 mL/min, RV:242±140 mL/min) and HLHS subjects (637±298 mL/min) after birth. Peak global longitudinal strain measurements did not differ in utero between control (LV:12.2±4.1%, RV:12.1±4.9%) and HLHS subjects (RV:12.7±4.2%). After birth, myocardial contraction increased for the control (LV:15.4±2.8%, RV:22.9±6.9%) and HLHS subjects (14.4±6.2%). Postnatal early filling mitral flow velocity for the control subjects (LV:58.8±17.6 cm/s) and early-filling tricuspid flow of the HLHS subjects (64.8±23.7cm/s) were similar, while the late filling velocity decreased for the control subject LV (33.5±8.1 cm/s) compared to the HLHS subjects (66.9±23.0 cm/s). Importantly, flow energy loss in the fetal HLHS hearts was increased (0.35±0.19 m3/s2) compared to the control subjects (LV:0.09±0.07 m3/s2, RV:0.17±0.12 m3/s2), and further increased postnatally for the HLHS subjects (0.55±0.24 m3/s2) compared to the control subjects (LV:0.23±0.20 m3/s2, RV:0.09±0.06 m3/s2). Conclusions We demonstrate the feasibility of integrated quantitative measurements of fetal and neonatal ventricular hemodynamics and biomechanics using only four-chamber B-mode and color Doppler recordings.

show abstract

MR imaging of the fetal heart

Cited by 18 publications

References 88 publications

Feasibility of ventricular volumetry by cardiovascular MRI to assess cardiac function in the fetal sheep

Feasibility of ventricular volumetry by cardiovascular MRI to assess cardiac function in the fetal sheep

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

Fetal and Neonatal Echocardiographic Analysis of Biomechanical Alterations for the Hypoplastic Left Heart

Contact Info

Product

Resources

About