Department of Radiology, Patnos State Hospital, Ağrı, Turkey.
Department of Radiology, Selcuk University, Faculty of Medicine, Konya, Turkey.
Eur J Radiol. 2023 Jun;163:110828. doi: 10.1016/j.ejrad.2023.110828. Epub 2023 Apr 8.
Fetal cardiac magnetic resonance imaging (FCMR) can be used as an imaging modality in fetal cardiovascular evaluation as studied in recent years. We aimed to evaluate cardiovascular morphology using FCMR and to observe the development of cardiovascular structures according to gestational age (GA) in pregnant women.
In our prospective study, 120 pregnant women between 19 and 37 weeks of gestation in whom absence of cardiac anomaly could not be excluded by ultrasonography (US) or, who were referred to us for magnetic resonance imaging (MRI) for suspected non-cardiovascular system pathology, were included. According to the axis of the fetal heart, axial, coronal, and sagittal multiplanar steady-state free precession (SSFP) and 'real time' untriggered SSFP sequence, respectively, were obtained. The morphology of the cardiovascular structures and their relationships with each other were evaluated, and their sizes were measured.
Seven cases (6.3%) contained motion artefacts that did not allow the assessment and measurement of cardiovascular morphology, and three (2.9%) cases with cardiac pathology in the analysed images were excluded from the study. The study included a total of 100 cases. Cardiac chamber diameter, heart diameter, heart length, heart area, thoracic diameter, and thoracic area were measured in all fetuses. The diameters of the aorta ascendens (Aa), aortic isthmus (Ai), aorta descendens (Ad), main pulmonary artery (MPA), ductus arteriosus (DA, superior vena cava (SVC), and inferior vena cava (IVC) were measured in all fetuses. The left pulmonary artery (LPA) was visualised in 89 patients (89%). The right PA (RPA) was visualised in 99 (99%) cases. Four pulmonary veins (PVs) were seen in 49 (49%) cases, three in 33 (33%), and two in 18 (18%). High correlation values were found for all diameter measurements performed with GW.
In cases where US cannot achieve adequate image quality, FCMR can contribute to diagnosis. The very short acquisition time and parallel imaging technique with the SSFP sequence allow for adequate image quality without maternal or fetal sedation.
胎儿心脏磁共振成像（FCMR）可作为近年研究中胎儿心血管评估的影像学方法。我们旨在通过 FCMR 评估心血管形态，并观察孕妇心血管结构随胎龄（GA）的发育情况。
在我们的前瞻性研究中，纳入了 120 名妊娠 19-37 周的孕妇，这些孕妇经超声（US）检查不能排除心脏异常，或因怀疑非心血管系统疾病而转至我们医院进行磁共振成像（MRI）检查。根据胎儿心脏的轴位，分别获得轴向、冠状和矢状多平面稳态自由进动（SSFP）和“实时”无触发 SSFP 序列。评估心血管结构的形态及其相互关系，并测量其大小。
7 例（6.3%）因运动伪影而无法评估和测量心血管形态，3 例（2.9%）分析图像中有心脏病变的病例被排除研究之外。本研究共纳入 100 例。所有胎儿均测量心腔直径、心脏直径、心脏长度、心脏面积、胸腔直径和胸腔面积。所有胎儿均测量升主动脉（Aa）、主动脉峡部（Ai）、降主动脉（Ad）、主肺动脉（MPA）、动脉导管（DA）、上腔静脉（SVC）和下腔静脉（IVC）的直径。89 例（89%）患者可显示左肺动脉（LPA），99 例（99%）患者可显示右肺动脉（RPA），49 例（49%）患者可显示 4 支肺静脉（PVs），33 例（33%）患者可显示 3 支，18 例（18%）患者可显示 2 支。GW 进行的所有直径测量均具有较高的相关性值。
在 US 无法获得足够图像质量的情况下，FCMR 可有助于诊断。SSFP 序列的采集时间非常短，并行成像技术允许在无需母亲或胎儿镇静的情况下获得足够的图像质量。
