Vollbrecht Thomas M, Hart Christopher, Zhang Shuo, Katemann Christoph, Isaak Alexander, Pieper Claus C, Kuetting Daniel, Faridi Bettina, Strizek Brigitte, Attenberger Ulrike, Kipfmueller Florian, Herberg Ulrike, Geipel Annegret, Luetkens Julian A
Departments of Diagnostic and Interventional Radiology (T.M.V., C.H., A.I., C.C.P., D.K., U.A., J.A.L.), Pediatric Cardiology (C.H., U.H.), Obstetrics and Prenatal Medicine (B.F., B.S., A.G.), and Neonatology and Pediatric Intensive Care Medicine (F.K.), University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; Quantitative Imaging Laboratory Bonn (QILaB) (T.M.V., C.H., A.I., D.K., J.A.L.), Bonn, Germany; and Philips GmbH Market DACH, Hamburg, Germany (S.Z., C.K.).
Radiol Cardiothorac Imaging. 2023 Feb 23;5(1):e220129. doi: 10.1148/ryct.220129. eCollection 2023 Feb.
To apply Doppler US (DUS)-gated fetal cardiac cine MRI in clinical routine and investigate diagnostic performance in complex congenital heart disease (CHD) compared with that of fetal echocardiography.
In this prospective study (May 2021 to March 2022), women with fetuses with CHD underwent fetal echocardiography and DUS-gated fetal cardiac MRI on the same day. For MRI, balanced steady-state free precession cine images were acquired in the axial and optional sagittal and/or coronal orientations. Overall image quality was assessed on a four-point Likert scale (from 1 = nondiagnostic to 4 = good image quality). The presence of abnormalities in 20 fetal cardiovascular features was independently assessed by using both modalities. The reference standard was postnatal examination results. Differences in sensitivities and specificities were determined by using a random-effects model.
The study included 23 participants (mean age, 32 years ± 5 [SD]; mean gestational age, 36 weeks ± 1). Fetal cardiac MRI was completed in all participants. The median overall image quality of DUS-gated cine images was 3 (IQR, 2.5-4). In 21 of 23 participants (91%), underlying CHD was correctly assessed by using fetal cardiac MRI. In one case, the correct diagnosis was made by using MRI only (situs inversus and congenitally corrected transposition of the great arteries). Sensitivities (91.8% [95% CI: 85.7, 95.1] vs 93.6% [95% CI: 88.8, 96.2]; = .53) and specificities (99.9% [95% CI: 99.2, 100] vs 99.9% [95% CI: 99.5, 100]; > .99) for the detection of abnormal cardiovascular features were comparable between MRI and echocardiography, respectively.
Using DUS-gated fetal cine cardiac MRI resulted in performance comparable with that of using fetal echocardiography for diagnosing complex fetal CHD. Pediatrics, MR-Fetal (Fetal MRI), Cardiac, Heart, Congenital, Fetal Imaging, Cardiac MRI, Prenatal, Congenital Heart DiseaseClinical trial registration no. NCT05066399 © RSNA, 2023See also the commentary by Biko and Fogel in this issue.
将多普勒超声（DUS）门控胎儿心脏电影磁共振成像（MRI）应用于临床常规检查，并与胎儿超声心动图相比，研究其在复杂先天性心脏病（CHD）中的诊断性能。
在这项前瞻性研究（2021年5月至2022年3月）中，患有CHD胎儿的孕妇在同一天接受了胎儿超声心动图和DUS门控胎儿心脏MRI检查。对于MRI，在轴向以及可选的矢状和/或冠状方向上采集平衡稳态自由进动电影图像。整体图像质量采用四点李克特量表进行评估（从1 = 无法诊断到4 = 图像质量良好）。通过两种检查方法独立评估20项胎儿心血管特征中异常情况的存在。参考标准为产后检查结果。采用随机效应模型确定敏感性和特异性的差异。
该研究纳入了23名参与者（平均年龄32岁±5[标准差]；平均孕周36周±1）。所有参与者均完成了胎儿心脏MRI检查。DUS门控电影图像的整体图像质量中位数为3（四分位间距，2.5 - 4）。在23名参与者中的21名（91%）中，通过胎儿心脏MRI正确评估了潜在的CHD。在1例中，仅通过MRI做出了正确诊断（内脏反位和先天性矫正型大动脉转位）。MRI和超声心动图在检测异常心血管特征方面的敏感性（91.8%[95%置信区间：85.7, 95.1]对93.6%[95%置信区间：88.8, 96.2]；P = 0.53）和特异性（99.9%[95%置信区间：99.2, 100]对99.9%[95%置信区间：99.5, 100]；P > 0.99）分别具有可比性。
使用DUS门控胎儿心脏电影MRI在诊断复杂胎儿CHD方面的性能与使用胎儿超声心动图相当。儿科学、MR - 胎儿（胎儿MRI）、心脏、先天性心脏病、胎儿成像、心脏MRI、产前、先天性心脏病临床试验注册号：NCT05066399 © RSNA，2023另见本期Biko和Fogel的评论。
