Fetal whole heart blood flow imaging using 4D cine MRI

Thomas A Roberts; Joshua F P van Amerom; Alena Uus; David F A Lloyd; Milou P M van Poppel; Anthony N Price; Jacques-Donald Tournier; Chloe A Mohanadass; Laurence H Jackson; Shaihan J Malik; Kuberan Pushparajah; Mary A Rutherford; Reza Rezavi; Maria Deprez; Joseph V Hajnal; David Lloyd

doi:10.1038/s41467-020-18790-1

Fetal whole heart blood flow imaging using 4D cine MRI

Thomas A Roberts, Joshua F P van Amerom, Alena Uus, David F A Lloyd, Milou P M van Poppel, Anthony N Price, Jacques-Donald Tournier, Chloe A Mohanadass, Laurence H Jackson, Shaihan J Malik, Kuberan Pushparajah, Mary A Rutherford, Reza Rezavi, Maria Deprez, Joseph V Hajnal, David Lloyd

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Abstract

Prenatal detection of congenital heart disease facilitates the opportunity for potentially life-saving care immediately after the baby is born. Echocardiography is routinely used for screening of morphological malformations, but functional measurements of blood flow are scarcely used in fetal echocardiography due to technical assumptions and issues of reliability. Magnetic resonance imaging (MRI) is readily used for quantification of abnormal blood flow in adult hearts, however, existing in utero approaches are compromised by spontaneous fetal motion. Here, we present and validate a novel method of MRI velocity-encoding combined with a motion-robust reconstruction framework for four-dimensional visualization and quantification of blood flow in the human fetal heart and major vessels. We demonstrate simultaneous 4D visualization of the anatomy and circulation, which we use to quantify flow rates through various major vessels. The framework introduced here could enable new clinical opportunities for assessment of the fetal cardiovascular system in both health and disease.

Original language	English
Article number	4992
Journal	Nature Communications
Volume	11
Issue number	1
Early online date	5 Oct 2020
DOIs	https://doi.org/10.1038/s41467-020-18790-1
Publication status	Published - 1 Dec 2020

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10.1038/s41467-020-18790-1Licence: CC BY

Fetal whole heart blood_ROBERTS_Accepted10September2020Publishedonline5October2020_GOLD VoR (CC BY)Final published version, 4.48 MBLicence: CC BY

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Roberts, T. A., van Amerom, J. F. P., Uus, A., Lloyd, D. F. A., van Poppel, M. P. M., Price, A. N., Tournier, J.-D., Mohanadass, C. A., Jackson, L. H., Malik, S. J., Pushparajah, K., Rutherford, M. A., Rezavi, R., Deprez, M., Hajnal, J. V., & Lloyd, D. (2020). Fetal whole heart blood flow imaging using 4D cine MRI. Nature Communications, 11(1), Article 4992. https://doi.org/10.1038/s41467-020-18790-1

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AU - Price, Anthony N

AU - Tournier, Jacques-Donald

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AU - Jackson, Laurence H

AU - Malik, Shaihan J

AU - Pushparajah, Kuberan

AU - Rutherford, Mary A

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Fetal whole heart blood flow imaging using 4D cine MRI

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