School of Biomedical Engineering & Imaging Sciences, King's College London, London, SE1 7EH, UK.
Department of Congenital Heart Disease, Evelina Children's Hospital, London, SE1 7EH, UK.
Nat Commun. 2020 Oct 5;11(1):4992. doi: 10.1038/s41467-020-18790-1.
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.
产前检测先天性心脏病可在婴儿出生后立即提供潜在的救生治疗机会。超声心动图通常用于筛查形态畸形，但由于技术假设和可靠性问题，胎儿超声心动图中很少使用血流功能测量。磁共振成像（MRI）可用于定量分析成人心脏的异常血流，但现有的宫内方法因胎儿自发性运动而受到限制。在这里，我们提出并验证了一种新的 MRI 速度编码方法，结合运动稳健重建框架，用于人类胎儿心脏和主要血管的四维血流可视化和定量。我们展示了同时进行的 4D 解剖和循环可视化，我们使用该方法来量化各种主要血管中的血流速度。这里介绍的框架可以为评估胎儿心血管系统的健康和疾病提供新的临床机会。
