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

Clinical Physiology and Functional Imaging
Misha BhatErik Hedström

Abstract

Limited visualization 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. Counselling and delivery planning may in those cases also be tentative. The recent fetal cardiac magnetic resonance (CMR) reconstruction method utilizing 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 malf...Continue Reading

References

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Citations

Jun 23, 2019·Journal of Magnetic Resonance Imaging : JMRI·Kostas HarisAnthony H Aletras
Oct 9, 2019·Topics in Magnetic Resonance Imaging : TMRI·Christopher W RoyChristopher K Macgowan
Oct 16, 2021·Journal of Magnetic Resonance Imaging : JMRI·Klas BerggrenErik Hedström
Feb 18, 2020·Fetal Diagnosis and Therapy·Liqun SunMike Seed

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Software Mentioned

iGRASP

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