Duan An Qi, Darby Jack R T, Soo Jia Yin, Lock Mitchell C, Zhu Meng Yuan, Flynn Lucy V, Perumal Sunthara Rajan, Macgowan Christopher K, Selvanayagam Joseph B, Morrison Janna L, Seed Mike
Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada.
Division of Cardiology, Hospital for Sick Children, Toronto, Ontario, Canada.
Am J Physiol Regul Integr Comp Physiol. 2019 Dec 1;317(6):R780-R792. doi: 10.1152/ajpregu.00273.2017. Epub 2017 Dec 13.
Phase-contrast cine MRI (PC-MRI) is the gold-standard noninvasive technique for measuring vessel blood flow and has previously been applied in the human fetal circulation. We aimed to assess the feasibility of using PC-MRI to define the distribution of the fetal circulation in sheep. Fetuses were catheterized at 119-120 days of gestation (term, 150 days) and underwent MRI at ∼123 days of gestation under isoflurane anesthesia, ventilated at a of 1.0. PC-MRI was performed using a fetal arterial blood pressure catheter signal for cardiac triggering. Blood flows were measured in the major fetal vessels, including the main pulmonary artery, ascending and descending aorta, superior vena cava, ductus arteriosus, left and right pulmonary arteries, umbilical vein, ductus venosus, and common carotid artery and were indexed to estimated fetal weight. The combined ventricular output, pulmonary blood flow, and flow across the foramen ovale were calculated from vessel flows. Intraobserver and interobserver agreement and reproducibility was assessed. Blood flow measurements were successfully obtained in 61 out of 74 vessels (82.4%) interrogated in 9 fetuses. There was good intraobserver [ = 0.998, < 0.0001; intraclass correlation (ICC) = 0.997] and interobserver agreement ( = 0.996, < 0.0001; ICC = 0.996). Repeated MRI measurements showed good reproducibility ( = 0.989, = 0.0002; ICC = 0.990). We conclude that PC-MRI using fetal catheters for gating triggers is feasible in the major vessels of late gestation fetal sheep. This approach may provide a useful new tool for assessing the circulatory characteristics of fetal sheep models of human disease, including fetal growth restriction and congenital heart disease.
相位对比电影磁共振成像(PC-MRI)是测量血管血流的金标准无创技术,此前已应用于人类胎儿循环。我们旨在评估使用PC-MRI确定绵羊胎儿循环分布的可行性。在妊娠119-120天(足月为150天)时对胎儿进行插管,并在妊娠约123天时在异氟烷麻醉下进行MRI检查,通气率为1.0。使用胎儿动脉血压导管信号进行心脏触发来进行PC-MRI检查。测量了主要胎儿血管中的血流,包括主肺动脉、升主动脉和降主动脉、上腔静脉、动脉导管、左右肺动脉、脐静脉、静脉导管和颈总动脉,并根据估计的胎儿体重进行指数化。根据血管血流计算联合心室输出量、肺血流量和卵圆孔处的血流。评估了观察者内和观察者间的一致性及可重复性。在9只胎儿的74条血管中,成功获得了61条血管(82.4%)的血流测量值。观察者内一致性良好[相关系数(r)=0.998,P<0.0001;组内相关系数(ICC)=0.997],观察者间一致性也良好(r=0.996,P<0.0001;ICC=0.996)。重复MRI测量显示出良好的可重复性(r=0.989,P=0.0002;ICC=0.990)。我们得出结论,使用胎儿导管进行门控触发的PC-MRI在妊娠晚期胎儿绵羊的主要血管中是可行的。这种方法可能为评估人类疾病胎儿绵羊模型的循环特征提供一种有用的新工具,包括胎儿生长受限和先天性心脏病。