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Circ Cardiovasc Imaging. 2018 Dec;11(12):e007745. doi: 10.1161/CIRCIMAGING.118.007745.

Preliminary Experience Using Motion Compensated CINE Magnetic Resonance Imaging to Visualise Fetal Congenital Heart Disease.

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Department of Medical Biophysics, University of Toronto, Canada (C.W.R., C.K.M.).
Division of Translational Medicine (C.W.R., E.M.S., E.J., C.K.M).
Division of Pediatric Cardiology, The Hospital for Sick Children, Toronto, Canada (D.M., W.M., S.-J.Y., E.J., M.S.).
Division of Imaging Sciences and Biomedical Engineering, King's College London, United Kingdom (D.F.A.L.).
Departments of Paediatric and Fetal Cardiology, Evelina Children's Hospital, London, United Kingdom (D.F.A.L.).
Departments of Pediatrics and Diagnostic Imaging, University of Toronto, Canada (S.-J.Y., E.J., M.S.).



Recent advances in cardiovascular magnetic resonance (CMR) imaging have facilitated CINE imaging of the fetal heart. In this work, a preliminary investigation of the utility of multislice CINE CMR for assessing fetal congenital heart disease is performed and compared with echocardiography.


Multislice CINE CMR and echocardiography images were acquired in 25 pregnant women wherein the fetus had a suspected congenital heart defect based on routine obstetric ultrasound. Pathognomonic images were identified for each subject for qualitative comparison of CMR and echocardiography. Quantitative comparison of CMR and echocardiography was then performed by 2 reviewers using a binary scoring of 9 fetal cardiac anatomic features (identifiable/not-identifiable). Pathognomonic images demonstrated the ability of CMR to visualize a variety of congenital heart defects. Overall CMR was able to identify the majority of the 9 assessed fetal cardiac anatomic features (reviewer 1, 7.1±2.1; reviewer 2, 6.7±2.3). Although both reviewers identified more anatomic features with echocardiography (reviewer 1, 7.8±2.3; reviewer 2, 7.5±2.4; P=0.01), combining information from both modalities enabled identification of additional anatomic features across subjects (reviewer 1, 8.4±1.3; reviewer 2, 8.4±1.2). The primary limiting factor for CMR was inadequate coverage of the fetal cardiac anatomy or noncontiguous slices because of gross fetal movement.


CINE CMR enables visualization of fetal congenital heart disease. This work demonstrates the potential of CMR for diagnosing congenital heart disease in utero in conjunction with echocardiography during late gestation.


echocardiography; fetal heart; heart defects, congenital; magnetic resonance imaging; pregnancy

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