Fetal dynamic magnetic resonance imaging using Doppler ultrasound gating for the assessment of the aortic isthmus: A feasibility study

Sousa, M Tavares de; Hecher, Kurt; Kording, Fabian; Yamamura, Jin; Lenz, Alexander; Adam, Gerhard; Bannas, Peter; Schoennagel, Bjoern P.

doi:10.1111/aogs.13957

Cited by 19 publications

(14 citation statements)

References 25 publications

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“…3,4 During the patency of the ductus arteriosus, severe constriction in the flow of the descending aorta will not occur antenatally, which leads to potential lethal consequences, such as a premature closure of the PDA during the postnatal life. [5][6][7] Findings and advances in imaging trends toward detailed morphology of the fetal aortic arch and isolated CoA may still avoid prenatal screening 8 ; therefore, how to avoid abortion due to overdiagnosis and how to avoid excessive rates of mortality and morbidity due to omission remain unclear. An increasing number of ultrasound indirect indicators have been proposed in fetuses in addition to ventricular asymmetry to potentially improve the detection rate of prenatal diagnosis for CoA.…”

Section: Introductionmentioning

confidence: 99%

A clinical prediction model to estimate the risk for coarctation of the aorta: From fetal to newborn life

Wang

Zhu

Liang

et al. 2022

J of Obstet and Gynaecol

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Purpose: This study aimed to develop a coarctation probability model incorporating prenatal cardiac sonographic markers to estimate the probability of an antenatal diagnosis of coarctation of the aorta (CoA).Methods: We reviewed 89 fetuses as a"investigation" cohort with prenatal suspicion for CoA and allotted to three ssubgroups:(1) severe CoA: symptoms onset of CoA and surgery within the rst three months (15);(2) mild CoA: surgery within four months-one year (29); (3) false-positive CoA: this outcome does not require surgery (45). Using logistic regression to creat the multi-parametric model, and validated using a "validation" cohort of 86 fetuses with suspected CoA subsequently.Results: The prediction model had optimal criterion >0.25 with sensitivity 97.7% and speci city 59.1%, the area under the receiver operator curve is 0.8 which makes sense in diagnosis of CoA and risk strati cation. The risk assessment demonstrated that fetuses with model probability>60% should make an inpatient observation for high risk of CoA whereas <15% should not undergo clinical follow-up imaging.Conclusion: Based on these results, we recommend measuring the model in all fetuses with suspected CoA may improve the accuracy of risk assessment. The objectivity of its parameters may allow its implementation working in multicenter studies of fetal cardiology.

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Section: Introductionmentioning

confidence: 99%

A clinical prediction model to estimate the risk for coarctation of the aorta: From fetal to newborn life

Wang

Zhu

Liang

et al. 2022

J of Obstet and Gynaecol

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“…[11][12][13][14][15][16] With the development of an MR-compatible Doppler ultrasound (DUS) device, 17 it is possible to acquire highresolution fetal CMR images without postprocessing, making fetal CMR potentially more clinically applicable. [18][19][20][21] Since echocardiography requires less time and resources compared with CMR, fetal CMR would likely serve as a complement to fetal echocardiography in challenging cases. Previous studies on the clinical utility of fetal CMR have shown that it can be used as an adjunct to echocardiography in cases with insufficient information from ultrasound.…”

Section: Introductionmentioning

confidence: 99%

Utility of Fetal Cardiovascular Magnetic Resonance for Prenatal Diagnosis of Complex Congenital Heart Defects

et al. 2021

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IMPORTANCE Prenatal diagnosis of complex congenital heart defects reduces mortality and morbidity in affected infants. However, fetal echocardiography can be limited by poor acoustic windows, and there is a need for improved diagnostic methods.OBJECTIVE To assess the clinical utility of fetal cardiovascular magnetic resonance imaging in cases in which fetal echocardiography could not visualize all relevant anatomy.

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“…Although limited by the small overall number of fetuses, these studies indicate the diagnostic and clinical benefit of gated fetal CMR. Dynamic fetal CMR was also applied for the evaluation of the aortic arch [67] (▶ Fig. 5), which in some cases is difficult to assess by echocardiography [6], e. g. when it is limited by maternal obesity or an unfavorable fetal position in utero [5,7].…”

Section: Doppler Ultrasound Gatingmentioning

confidence: 99%

“…5), which in some cases is difficult to assess by echocardiography [6], e. g. when it is limited by maternal obesity or an unfavorable fetal position in utero [5,7]. Comparison of DUS-gated dynamic CMR with the reference standard of echocardiography in 19 healthy fetuses revealed good agreement of aortic isthmus diameters and in identifying one pathological case of aortic coarctation [67]. In a pilot project, 4 D flow MRI of the aorta seemed feasible in near-term human fetuses using DUS gating (▶ Fig.…”

Section: Doppler Ultrasound Gatingmentioning

confidence: 99%

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Fetal Cardiovascular MRI – A Systemic Review of the Literature: Challenges, New Technical Developments, and Perspectives

Knapp

Sousa

Schönnagel

2022

Rofo

Self Cite

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Background Fetal magnetic resonance imaging (MRI) has become a valuable adjunct to ultrasound in the prenatal diagnosis of congenital pathologies of the central nervous system, thorax, and abdomen. Fetal cardiovascular magnetic resonance (CMR) was limited, mainly by the lack of cardiac gating, and has only recently evolved due to technical developments. Method A literature search was performed on PubMed, focusing on technical advancements to perform fetal CMR. In total, 20 publications on cardiac gating techniques in the human fetus were analyzed. Results Fetal MRI is a safe imaging method with no developmental impairments found to be associated with in utero exposure to MRI. Fetal CMR is challenging due to general drawbacks (e. g., fetal motion) and specific limitations such as the difficulty to generate a cardiac gating signal to achieve high spatiotemporal resolution. Promising technical advancements include new methods for fetal cardiac gating, based on novel post-processing approaches and an external hardware device, as well as motion compensation and acceleration techniques. Conclusion Newly developed direct and indirect gating approaches were successfully applied to achieve high-quality morphologic and functional imaging as well as quantitative assessment of fetal hemodynamics in research settings. In cases when prenatal echocardiography is limited, e. g., by an unfavorable fetal position in utero, or when its results are inconclusive, fetal CMR could potentially serve as a valuable adjunct in the prenatal assessment of congenital cardiovascular malformations. However, sufficient data on the diagnostic performance and clinical benefit of new fetal CMR techniques is still lacking. Key Points: Citation Format

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Fetal dynamic magnetic resonance imaging using Doppler ultrasound gating for the assessment of the aortic isthmus: A feasibility study

Abstract: This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Cited by 19 publications

References 25 publications

A clinical prediction model to estimate the risk for coarctation of the aorta: From fetal to newborn life

A clinical prediction model to estimate the risk for coarctation of the aorta: From fetal to newborn life

Utility of Fetal Cardiovascular Magnetic Resonance for Prenatal Diagnosis of Complex Congenital Heart Defects

Fetal Cardiovascular MRI – A Systemic Review of the Literature: Challenges, New Technical Developments, and Perspectives

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