Fetal iGRASP cine CMR assisting in prenatal diagnosis of complicated cardiac malformation with impact on delivery planning

Research output: Contribution to journalArticle

Abstract

Limited visualisation of the fetal heart and vessels by fetal ultrasound due to suboptimal fetal position, patient habitus and skeletal calcification may lead to missed diagnosis, overdiagnosis and parental uncertainty. Counseling and delivery planning may in those cases also be tentative. The recent fetal cardiac magnetic resonance (CMR) reconstruction method utilising tiny golden angle iGRASP (iterative Golden-angle RAdial Sparse Parallel MRI) allows for cine imaging of the fetal heart for use in clinical practice. This case describes an unbalanced common atrioventricular canal where limited ultrasound image quality and visibility of the aortic arch precluded confirming or ruling out presence of a ventricular septal defect. Need of prostaglandins or neonatal intervention was thus uncertain. Cardiovascular magnetic resonance imaging confirmed ultrasound findings and added value by ruling out a significant ventricular septal defect and diagnosing arch hypoplasia. This confirmed the need of patient relocation for delivery at a paediatric cardiothoracic surgery centre and prostaglandins could be initiated before the standard postnatal ultrasound. The applied CMR method can thus improve diagnosis of complicated fetal cardiac malformation and has direct clinical impact. This article is protected by copyright. All rights reserved.

Details

Authors
Organisations
External organisations
  • Skåne University Hospital
  • Aristotle University of Thessaloniki
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Cardiac and Cardiovascular Systems
  • Pediatrics
  • Radiology, Nuclear Medicine and Medical Imaging
Original languageEnglish
Pages (from-to)231-235
JournalClinical Physiology and Functional Imaging
Volume39
Issue number4
Early online date2019 Feb 20
Publication statusPublished - 2019
Publication categoryResearch
Peer-reviewedYes