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Fetal iGRASP cine CMR assisting in prenatal diagnosis of complicated cardiac malformation with impact on delivery planning.

TitleFetal iGRASP cine CMR assisting in prenatal diagnosis of complicated cardiac malformation with impact on delivery planning.
Publication TypeJournal Article
Year of Publication2019
AuthorsBhat, M., Haris K., Bidhult S., Liuba P., Aletras A. H., & Hedström E.
JournalClin Physiol Funct Imaging
Volume39
Issue4
Pagination231-235
Date Published2019 Jul
ISSN1475-097X
KeywordsClinical Decision-Making, Female, Fetal Heart, Heart Defects, Congenital, Humans, Labor, Obstetric, Magnetic Resonance Imaging, Cine, Predictive Value of Tests, Pregnancy, Prenatal Diagnosis, Reproducibility of Results, Ultrasonography, Prenatal
Abstract

Limited visualization of the fetal heart and vessels by fetal ultrasound due to suboptimal fetal position, patient habitus and skeletal calcification may lead to missed diagnosis, overdiagnosis and parental uncertainty. Counselling and delivery planning may in those cases also be tentative. The recent fetal cardiac magnetic resonance (CMR) reconstruction method utilizing tiny golden-angle iGRASP (iterative Golden-angle RAdial Sparse Parallel MRI) allows for cine imaging of the fetal heart for use in clinical practice. This case describes an unbalanced common atrioventricular canal where limited ultrasound image quality and visibility of the aortic arch precluded confirming or ruling out presence of a ventricular septal defect. Need of prostaglandins or neonatal intervention was thus uncertain. Cardiovascular magnetic resonance imaging confirmed ultrasound findings and added value by ruling out a significant ventricular septal defect and diagnosing arch hypoplasia. This confirmed the need of patient relocation for delivery at a paediatric cardiothoracic surgery centre and prostaglandins could be initiated before the standard postnatal ultrasound. The applied CMR method can thus improve diagnosis of complicated fetal cardiac malformation and has direct clinical impact.

DOI10.1111/cpf.12566
Alternate JournalClin Physiol Funct Imaging
PubMed ID30785656
PubMed Central IDPMC6850003
Grant List / / Lund University Medical Faculty /
/ / Swedish Heart-Lung Foundation /
/ / Skane University Hospital Lund /
/ / Region of Skane /

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