Preliminary Experience Using Motion Compensated CINE Magnetic Resonance Imaging to Visualise Fetal Congenital Heart Disease

TY - JOUR

T1 - Preliminary Experience Using Motion Compensated CINE Magnetic Resonance Imaging to Visualise Fetal Congenital Heart Disease

AU - Roy, Christopher W.

AU - Marini, Davide

AU - Lloyd, David F.A.

AU - Mawad, Wadi

AU - Yoo, Shi Joon

AU - Schrauben, Eric M.

AU - Jaeggi, Edgar

AU - Seed, Mike

AU - Macgowan, Christopher K.

PY - 2018/12/1

Y1 - 2018/12/1

N2 - BACKGROUND: Recent advances in cardiovascular magnetic resonance (CMR) imaging have facilitated CINE imaging of the fetal heart. In this work, a preliminary investigation of the utility of multislice CINE CMR for assessing fetal congenital heart disease is performed and compared with echocardiography. METHODS AND RESULTS: Multislice CINE CMR and echocardiography images were acquired in 25 pregnant women wherein the fetus had a suspected congenital heart defect based on routine obstetric ultrasound. Pathognomonic images were identified for each subject for qualitative comparison of CMR and echocardiography. Quantitative comparison of CMR and echocardiography was then performed by 2 reviewers using a binary scoring of 9 fetal cardiac anatomic features (identifiable/not-identifiable). Pathognomonic images demonstrated the ability of CMR to visualize a variety of congenital heart defects. Overall CMR was able to identify the majority of the 9 assessed fetal cardiac anatomic features (reviewer 1, 7.1±2.1; reviewer 2, 6.7±2.3). Although both reviewers identified more anatomic features with echocardiography (reviewer 1, 7.8±2.3; reviewer 2, 7.5±2.4; P=0.01), combining information from both modalities enabled identification of additional anatomic features across subjects (reviewer 1, 8.4±1.3; reviewer 2, 8.4±1.2). The primary limiting factor for CMR was inadequate coverage of the fetal cardiac anatomy or noncontiguous slices because of gross fetal movement. CONCLUSIONS: CINE CMR enables visualization of fetal congenital heart disease. This work demonstrates the potential of CMR for diagnosing congenital heart disease in utero in conjunction with echocardiography during late gestation.

AB - BACKGROUND: Recent advances in cardiovascular magnetic resonance (CMR) imaging have facilitated CINE imaging of the fetal heart. In this work, a preliminary investigation of the utility of multislice CINE CMR for assessing fetal congenital heart disease is performed and compared with echocardiography. METHODS AND RESULTS: Multislice CINE CMR and echocardiography images were acquired in 25 pregnant women wherein the fetus had a suspected congenital heart defect based on routine obstetric ultrasound. Pathognomonic images were identified for each subject for qualitative comparison of CMR and echocardiography. Quantitative comparison of CMR and echocardiography was then performed by 2 reviewers using a binary scoring of 9 fetal cardiac anatomic features (identifiable/not-identifiable). Pathognomonic images demonstrated the ability of CMR to visualize a variety of congenital heart defects. Overall CMR was able to identify the majority of the 9 assessed fetal cardiac anatomic features (reviewer 1, 7.1±2.1; reviewer 2, 6.7±2.3). Although both reviewers identified more anatomic features with echocardiography (reviewer 1, 7.8±2.3; reviewer 2, 7.5±2.4; P=0.01), combining information from both modalities enabled identification of additional anatomic features across subjects (reviewer 1, 8.4±1.3; reviewer 2, 8.4±1.2). The primary limiting factor for CMR was inadequate coverage of the fetal cardiac anatomy or noncontiguous slices because of gross fetal movement. CONCLUSIONS: CINE CMR enables visualization of fetal congenital heart disease. This work demonstrates the potential of CMR for diagnosing congenital heart disease in utero in conjunction with echocardiography during late gestation.

KW - echocardiography

KW - fetal heart

KW - heart defects, congenital

KW - magnetic resonance imaging

KW - pregnancy

UR - http://www.scopus.com/inward/record.url?scp=85058727565&partnerID=8YFLogxK

U2 - 10.1161/CIRCIMAGING.118.007745

DO - 10.1161/CIRCIMAGING.118.007745

M3 - Article

C2 - 30558501

AN - SCOPUS:85058727565

SN - 1941-9651

VL - 11

SP - e007745

JO - Circulation. Cardiovascular imaging

JF - Circulation. Cardiovascular imaging

IS - 12

ER -