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Diagn Interv Imaging. 2019 Feb;100(2):109-116. doi: 10.1016/j.diii.2018.11.004. Epub 2018 Dec 7.

Evaluation of septal insertion of atrioventricular valves in fetuses by postmortem 4.7 Tesla cardiac MRI: A feasibility study.

Author information

1
Laboratoire d'imagerie biomédicale, CNRS 7371, Inserm 1146, department of radiology, Sorbonne université, hôpital Trousseau, hôpitaux universitaires de l'Est parisien, AP-HP, 75012 Paris, France. Electronic address: eleonore.blondiaux@aphp.fr.
2
Inserm U970, plateforme imageries du vivant, Paris cardiovascular research center, université Paris Descartes, Sorbonne Paris cité, 75015 Paris, France.
3
Faculté de médecine, department of fetal medicine, Sorbonne université, hôpital Trousseau, hôpitaux universitaires de l'Est parisien, AP-HP, 75012 Paris, France.
4
LIC EA 4393, department of public health, université Paris Est Créteil, hôpital Henri-Mondor, AP-HP, 94000 Créteil, France.
5
Congenital and Pediatric Cardiology Unit, Centre de Référence Maladies Cardiaques Congénitales Complexes-M3C, hôpital Necker-Enfants Malades, AP-HP, 75006 Paris, France; Université Paris-Descartes, Sorbonne Paris Cité, 75005 Paris, France.

Abstract

PURPOSE:

The purpose of this study was to compare non-invasive high-spatial-resolution postmortem cardiac magnetic resonance imaging (MRI) and autopsy findings for evaluating the septal insertion of atrioventricular valves in fetuses.

MATERIALS AND METHODS:

Five fetal heart specimens including two normal hearts, one heart with complete atrioventricular septal defect (AVSD) and two hearts with linear insertion of atrioventricular valves (LIAVV; gestational age 17 to 34 weeks) were studied with cardiac MRI using a 4.7 T MRI scanner without sample preparation. Three (3D) and two-dimensional (2D) turbo-RARE (rapid imaging with refocused echoes) sequences in four-chamber and left-ventricular long-axis planes were obtained with a minimal isotropic/in-plane resolution of 156μm. Nonparametric tests were performed to compare the distance between insertions of medial leaflets of the atrioventricular valves and the inlet/outlet distance ratio between MRI and autopsy findings in normal, complete AVSD and with linear insertion of atrioventricular valves (LIAVV) fetal hearts.

RESULTS:

Despite apparent differences between LIAVV/normal hearts, no significant differences were found between differential insertion of medial leaflets and inlet/outlet distance ratios with both techniques. Very good to excellent reliability between both techniques was found for differential insertion (ICC: 87.2%; 95% CI: -21.7%, 99.1%) (P=0.963) and inlet/outlet distance ratio (ICC 98.3%; 95%CI: 85.2%, 99.8%) (P=0.537) measurements.

CONCLUSION:

Postmortem cardiac MRI could replace autopsy for assessing normal or abnormal septal insertion of atrioventricular valves in fetuses without requiring specific preparation of the heart.

KEYWORDS:

Atrioventricular septal defect; Congenital heart defect; Linear insertion of atrioventricular valves; Postmortem MRI

PMID:
30527913
DOI:
10.1016/j.diii.2018.11.004
[Indexed for MEDLINE]

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