Fetal MRI to Assess an Aberrant Artery in Bronchopulmonary Sequestration: The Utility of a Single-Shot Turbo Spin Echo Sequence
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Detecting an aberrant artery is the key to diagnosing bronchopulmonary sequestration (BPS) on fetal MRI. Few reports describe the best sequence to use for this purpose. We compared visualization of an aberrant artery in BPS on fetal MRI using single-shot turbo spin echo (SSTSE) and balanced steady state free precession (b-SSFP) sequences. We retrospectively reviewed the fetal MRI of 27 fetuses in which BPS was diagnosed prenatally (2003–2016). From these we selected 15 fetuses with the pathological diagnosis of BPS made postnatally at operation. All fetuses were examined in 1.5 T MRI units using SSTSE and b-SSFP sequences (mean gestational age: 28.4 ± 3.4 weeks). Two pediatric radiologists compared visualization of the aberrant artery using the two sequences. The presence of an aberrant artery was confirmed by postnatal contrast-enhanced CT. The influence of arterial diameter and background heterogeneity of the lung on the diagnostic power was also evaluated. All 15 fetuses clearly showed the aberrant artery on the SSTSE sequence. Conversely, the aberrant arteries detected on the SSTSE sequence were absent in the b-SSFP sequences of eight fetuses, and the other seven fetuses showed ambiguous visualization compared with the SSTSE sequence. Arterial diameter and background heterogeneity did not affect the diagnostic power in either sequence. The SSTSE sequence was superior to the b-SSFP sequence for clear visualization of the aberrant artery in BPS, regardless of the arterial diameter and background heterogeneity.
KeywordsBronchopulmonary sequestration Aberrant artery Single-shot turbo spin echo sequence Steady state free precession sequence MRI Fetus
This article was supported by a Grant from the National Center for Child Health and Development, Japan, 26-20. We thank Hiroshi Nagamatsu (principal technologist), Rumi Imai, Chiharu Hiramatsu, Tomoyuki Maruyama, Keisuke Asano, and Taizo Somemori as MRI technologists of the National Center for Child Health and Development.
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Conflict of interest
The authors declare that they have no conflict of interest.
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