European Radiology

, Volume 14, Issue 11, pp 2120–2124 | Cite as

Truncus arteriosus communis in a midtrimester fetus: comparison of prenatal ultrasound and MRI with postmortem MRI and autopsy

  • Matthias R. Mühler
  • Anett Rake
  • Michael Schwabe
  • Rabih Chaoui
  • Kay-Sven Heling
  • Christiane Planke
  • Alexander Lembcke
  • Thomas Fischer
  • Dietmar Kivelitz
Pediatric
First Online:
Received:
Revised:
Accepted:

Abstract

Different techniques are used in fetal cardiology, and their accuracy has been demonstrated on several occasions. Color Doppler US has proved to be a reliable and valuable tool in the diagnosis of fetal cardiac abnormalities. Magnetic resonance imaging (MRI) of the fetal heart has, so far, played no role in prenatal diagnostics. We report on a truncus arteriosus communis diagnosed prenatally during a screening ultrasound at 22 weeks of gestation. In addition to real-time ultrasound and color Doppler echocardiography, fetal MRI was performed. Fetal echocardiography arose suspicion of a type I common trunk. Fetal MR showed solely a widened vessel coursing retrocardially and additionally an inhomogeneous fluid distribution of the lung not shown on prenatal US. After termination of pregnancy at 23 weeks of gestation, MR fetography and autopsy were performed, and both found a type II common trunk. MR autopsy of the heart was very reliable in this case and could be an alternative when fetal pathology is not available for different reasons. Postmortem MRI was also able to demonstrate the inhomogeneous fluid distribution in the lung, which was confirmed by autopsy. Fetal and postmortem MR was reliable in the detection of an inhomogeneous fluid distribution in the lung not shown on prenatal US, providing a relevant additional finding to US. Therefore, MRI should be used more often in fetal cardiology, although it still must be further developed.

Keywords

Truncus arteriosus communis Fetal ultrasound Fetal MRI MR fetography Cardiac malformation Autopsy 
This is a preview of subscription content, log in to check access.

References

  1. 1.
    Girard N (2002) Fetal MR imaging. Eur Radiol 12:1869–1871PubMedGoogle Scholar
  2. 2.
    Ertl-Wagner B, Lienemann A, Strauss A, Reiser MF (2002) Fetal magnetic resonance imaging: indications, technique, anatomical considerations and a review of fetal abnormalities. Eur Radiol 12:1931–1940PubMedGoogle Scholar
  3. 3.
    Carvalho G, Silva AA, Bestetti RB, Leme-Neto AC (2002) Long-term survival in truncus arteriosus communis type A1 associated with Ehlers–Danlos syndrome—a case report. Angiology 53:363–365PubMedGoogle Scholar
  4. 4.
    Malec E, Werynski P, Mroczek T, Mikuta M, Kolcz J, Januszewska K, Pajak J (2000) Results of surgical treatment of congenital heart defects in infants below 2,500 grams. Przegl Lek 57:187–190PubMedGoogle Scholar
  5. 5.
    Malec E, Mroczek T, Pajak J, Kordon Z (2000) Operative treatment of truncus arteriosus communis coexisting with tricuspid atresia. Ann Thorac Surg 69:278–280CrossRefPubMedGoogle Scholar
  6. 6.
    Hartyanszky I, Kadar K, Prodan Z, Szekely A, Tamas C (1999) Primary reconstruction of the common truncus arteriosus in infants, using modified pulmonary homograft. Orv Hetil 140:1361–1363PubMedGoogle Scholar
  7. 7.
    Sadler TW (1998) Herz und Gefäße. In: Sadler TW (ed) Medizinische Embryologie. Georg Thieme, Stuttgart, pp 189–218Google Scholar
  8. 8.
    Böhm N (1984) Herz und Gefäße. In: Böhm N (ed) Kinderpathologie. Schattauer, Stuttgart, pp 146–175Google Scholar
  9. 9.
    Pauliks LB, Bharati S, Magid MS, Friedman DM (2000) A cross between truncus arteriosus communis and aortopulmonary septal defect: a hitherto undescribed entity. Pediatr Cardiol 21:477–479CrossRefPubMedGoogle Scholar
  10. 10.
    Murdison KA, McLean DA, Carpenter B, Duncan WJ (1996) Truncus arteriosus communis associated with mitral valve and left ventricular hypoplasia without ventricular septal defect: unique combination. Pediatr Cardiol 17:322–326CrossRefPubMedGoogle Scholar
  11. 11.
    Oren H, Ozkan H, Oren B, Kupelioglu A, Cevik N (1994) A case of common truncus arteriosus with rare cardiac abnormalities. Turk J Pediatr 36:171–174PubMedGoogle Scholar
  12. 12.
    Calder L, Van Praagh R, Van Praagh S, Sears WP, Corwin R, Levy A, Keith JD, Paul MH (1976) Truncus arteriosus communis. Clinical, angiocardiographic, and pathologic findings in 100 patients. Am Heart J 92:23–38PubMedGoogle Scholar
  13. 13.
    Rosenquist GC, Bharati S, McAllister HA, Lev M (1976) Truncus arteriosus communis: truncal valve anomalies associated with small conal or truncal septal defects. Am J Cardiol 37:410–412CrossRefPubMedGoogle Scholar
  14. 14.
    Mas C, Delatycki MB, Weintraub RG (1999) Persistent truncus arteriosus in monozygotic twins: case report and literature review. Am J Med Genet 82:146–148CrossRefPubMedGoogle Scholar
  15. 15.
    Machlitt A, Tennstedt C, Korner H, Bommer C, Chaoui R (2002) Prenatal diagnosis of 22q11 microdeletion in an early second-trimester fetus with conotruncal anomaly presenting with increased nuchal translucency and bilateral intracardiac echogenic foci. Ultrasound Obstet Gynecol 19:510–513CrossRefPubMedGoogle Scholar
  16. 16.
    Momma K, Ando M, Matsuoka R (1997) Truncus arteriosus communis associated with chromosome 22q11 deletion. J Am Coll Cardiol 30:1067–1071CrossRefPubMedGoogle Scholar
  17. 17.
    Tennstedt C, Chaoui R, Korner H, Dietel M (1999) Spectrum of congenital heart defects and extracardiac malformations associated with chromosomal abnormalities: results of a seven year necropsy study. Heart 82:34–39PubMedGoogle Scholar
  18. 18.
    Mehraein Y, Wippermann CF, Michel-Behnke I, Nhan Ngo TK, Hillig U, Giersberg M, Aulepp U, Barth H, Fritz B, Rehder H (1997) Microdeletion 22q11 in complex cardiovascular malformations. Hum Genet 99:433–442CrossRefPubMedGoogle Scholar
  19. 19.
    Trost D, Engels H, Bauriedel G, Wiebe W, Schwanitz G (1999) Congenital cardiovascular malformations and chromosome microdeletions in 22q11.2. Dtsch Med Wochenschr 124:3–7PubMedGoogle Scholar
  20. 20.
    McElhinney DB, Reddy VM, Feuerstein BG, Marx GR, Hanley FL (1997) Intraoperative discovery of neuroblastoma in an infant with pulmonary atresia. Ann Thorac Surg 64:1827–1829CrossRefPubMedGoogle Scholar
  21. 21.
    Nouet N, Doz F, Dessemme P, Lacaille F, Bonnet D (2002) Pepper syndrome, truncus arteriosus communis and abnormal pulmonary venous return: an unusual association. Eur J Pediatr 161:114–115CrossRefPubMedGoogle Scholar
  22. 22.
    Michel SC, Rake A, Keller TM, Huch R, Konig V, Seifert B, Marincek B, Kubik-Huch RA (2003) Original report. Fetal cardiographic monitoring during 1.5-T MR imaging. Am J Roentgenol 180:1159–1164Google Scholar
  23. 23.
    Levine D, Barnewolt CE, Mehta TS, Trop I, Estroff J, Wong G (2003) Fetal thoracic abnormalities: MR imaging. Radiology 228:379–388PubMedGoogle Scholar
  24. 24.
    Kivelitz DE, Muhler M, Rake A, Scheer I, Chaoui R (2003) MRI of cardiac rhabdomyoma in the fetus. Eur Radiol 14:1513–1516PubMedGoogle Scholar
  25. 25.
    Kurihara N, Tokieda K, Ikeda K, Mori K, Hokuto I, Nishimura O, Ishimoto H, Yuasa Y (2001) Prenatal MR findings in a case of aneurysm of the vein of Galen. Pediatr Radiol 31:160–162CrossRefPubMedGoogle Scholar
  26. 26.
    Moore KL (1990) Das Respirationssystem. In: Moore KL (ed) Grundlagen der Medizinischen Embryologie. Ferdinand Enke, Stuttgart, pp 88–96Google Scholar
  27. 27.
    Rake A, Mühler M, Schwabe M, Tennstedt C, Kivelitz D, Chaoui R (2002) Comparison of postmortem MRI with antenatal ultrasound findings and clinical autopsy in fetal malformations. Ultrasound Obstet Gynecol 20:S1–S76Google Scholar
  28. 28.
    Breysem L, Bosmans H, Dymarkowski S, Schoubroeck DV, Witters I, Deprest J, Demaerel P, Vanbeckevoort D, Vanhole C, Casaer P et al (2003) The value of fast MR imaging as an adjunct to ultrasound in prenatal diagnosis. Eur Radiol 13:1538–1548CrossRefPubMedGoogle Scholar
  29. 29.
    Huisman TA, Wisser J, Stallmach T, Krestin GP, Huch R, Kubik-Huch RA (2002) MR autopsy in fetuses. Fetal Diagn Ther 17:58–64CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • Matthias R. Mühler
    • 1
  • Anett Rake
    • 2
  • Michael Schwabe
    • 3
  • Rabih Chaoui
    • 2
  • Kay-Sven Heling
    • 2
  • Christiane Planke
    • 4
  • Alexander Lembcke
    • 1
  • Thomas Fischer
    • 1
  • Dietmar Kivelitz
    • 1
  1. 1.Department of Radiology, CharitéCCMBerlinGermany
  2. 2.Section for Prenatal Medicine, Department of Gynecology and Obstetrics, CharitéCCMBerlinGermany
  3. 3.Department of Pathology, CharitéCCMBerlinGermany
  4. 4.Department of Pediatrics and Juvenile MedicineCarl-Thiem-Klinikum CottbusCottbusGermany

Personalised recommendations