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

作者: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; Razavi Reza
来源:Prenatal Diagnosis, 2016, 36(10): 916-925.
DOI:10.1002/pd.4912

摘要

ObjectivesFetal 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. MethodsCases 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. ResultsTwenty-two fetal cardiac MRIs were performed over 12months, at mean gestation of 32weeks (26-38weeks). 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. ConclusionsFetal 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.

  • 出版日期2016-10