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Fetal Magnetic Resonance Imaging of Malformations Associated with Heterotaxy.

ABSTRACT: Magnetic resonance imaging (MRI) is increasingly used as an investigation during fetal life, particularly for assessment of intracranial masses, congenital diaphragmatic hernia, myelomeningocele, and abdominal masses. As the number of scans increases, so is the variety of congenital malformations being recognized. It is axiomatic that interpretation of the findings is enhanced when attention is paid to the likely findings in the setting of known syndromes, this information then dictating the need for additional acquisition of images. One such syndrome is so-called "visceral heterotaxy", in which there is typically an isomeric, rather than a lateralized, arrangement of the thoracic and abdominal organs. Typically associated with complex congenital cardiac malformations, heterotaxy can also involve the central nervous system, and produce pulmonary, gastrointestinal, immunologic, and genitourinary malformations. In this review, we discuss how these findings can be demonstrated using fetal MRI.

SUBMITTER: Loomba R

PROVIDER: S-EPMC4494530 | biostudies-other | 2015 May

REPOSITORIES: biostudies-other

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Fetal Magnetic Resonance Imaging of Malformations Associated with Heterotaxy.

Loomba Rohit R Shah Parinda H PH Anderson Robert H RH

Cureus 20150521 5

Magnetic resonance imaging (MRI) is increasingly used as an investigation during fetal life, particularly for assessment of intracranial masses, congenital diaphragmatic hernia, myelomeningocele, and abdominal masses. As the number of scans increases, so is the variety of congenital malformations being recognized. It is axiomatic that interpretation of the findings is enhanced when attention is paid to the likely findings in the setting of known syndromes, this information then dictating the nee ...[more]

PMID: 26180693

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Project description:PurposeTo image multidimensional flow in fetuses using golden-angle radial phase contrast cardiovascular magnetic resonance (PC-CMR) with motion correction and retrospective gating.MethodsA novel PC-CMR method was developed using an ungated golden-angle radial acquisition with continuously incremented velocity encoding. Healthy subjects (n = 5, 27 ± 3 years, males) and pregnant females (n = 5, 34 ± 2 weeks gestation) were imaged at 3 T using the proposed sequence. Real-time reconstructions were first performed for retrospective motion correction and cardiac gating (using metric optimized gating, MOG). CINE reconstructions of multidimensional flow were then performed using the corrected and gated data.ResultsIn adults, flows obtained using the proposed method agreed strongly with those obtained using a conventionally gated Cartesian acquisition. Across the five adults, bias and limits of agreement were - 1.0 cm/s and [- 5.1, 3.2] cm/s for mean velocities and - 1.1 cm/s and [- 6.5, 4.3] cm/s for peak velocities. Temporal correlation between corresponding waveforms was also high (R~ 0.98). Calculated timing errors between MOG and pulse-gating RR intervals were low (~ 20 ms). First insights into multidimensional fetal blood flows were achieved. Inter-subject consistency in fetal descending aortic flows (n = 3) was strong with an average velocity of 27.1 ± 0.4 cm/s, peak systolic velocity of 70.0 ± 1.8 cm/s and an intra-class correlation coefficient of 0.95 between the velocity waveforms. In one fetal case, high flow waveform reproducibility was demonstrated in the ascending aorta (R = 0.97) and main pulmonary artery (R = 0.99).ConclusionMultidimensional PC-CMR of fetal flow was developed and validated, incorporating retrospective motion compensation and cardiac gating. Using this method, the first quantification and visualization of multidimensional fetal blood flow was achieved using CMR.

Dataset Information

Fetal Magnetic Resonance Imaging of Malformations Associated with Heterotaxy.

Publications

Fetal Magnetic Resonance Imaging of Malformations Associated with Heterotaxy.

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