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Fetal MRI of the cardiovascular system: role of steady-state free precession sequences for the evaluation of normal and pathological appearances

Risonanza magnetica fetale del distretto cardiovascolare: ruolo delle sequenze steady state free precession per la visualizzazione degli aspetti normali e patologici

  • Cardiac Radiology/Cardioradiologia
  • Published:
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Abstract

Purpose

This study aimed to evaluate the feasibility of fetal magnetic resonance imaging (MRI) with steady-state free precession (SSFP) sequences to visualise the normal and pathological appearances of the cardiovascular system.

Materials and methods

This is a prospective observational study of 83 pregnant women who underwent fetal cardiac MRI: 43 patients (cases) had echocardiographic suspicion of congenital heart disease; 40 patients (controls) did not. Fetal cardiac MRI consisted of a static phase with multiplanar SSFP sequences and a dynamic phase with real-time SSFP sequences. Two radiologists evaluated the diagnostic quality of the SSFP images in both the controls and cases, the MRI morphological and functional features in the controls and the MRI signs of congenital heart disease in the cases.

Results

In both groups, SSFP sequences produced goodquality MR images and good visualisation of morphological features. Functional data appeared to be unavailable due to the current small temporal resolution and the technical impossibility of fetal cardiac triggering. MRI detected direct signs of congenital heart disease in 21 fetuses, indirect signs in six and both signs in 15.

Conclusions

SSFP sequences are effective in demonstrating the morphological features of the cardiovascular system, whereas dynamic SSFP cine-MRI sequences may provide adjunctive albeit suboptimal functional information.

Riassunto

Obiettivo

Dimostrare la possibilità di visualizzare gli aspetti anatomici e patologici del distretto cardiovascolare attraverso lo studio di risonanza magnetica (RM) fetale con sequenze steady state free precession (SSFP).

Materiali e metodi

Si stratta di uno studio osservazionale prospettico di 83 donne in gravidanza sottoposte ad esami di RM cardiaca fetale: 43 con il sospetto ecocardiografico di patologia cardiovascolare (casi) e 40 senza (controlli). Lo studio RM cardiaco fetale consiste in una fase statica con sequenze multiplanari SSFP ed in una fase dinamica con sequenze SSFP in tempo reale. Due radiologi hanno valutato: la validità diagnostica delle immagini ottenute nei casi e nei controlli; gli aspetti morfologici e funzionali evidenziabili con RM nei controlli; i segni semeiotici della patologia cardiovascolare nei casi.

Risultati

In entrambi i gruppi le sequenze SSFP hanno permesso di ottenere immagini diagnostiche del cuore e dei grossi vasi ed una buona valutazione degli aspetti morfologici. La funzionalità cardiaca non è risultata valutabile per la ridotta risoluzione temporale delle sequenze e l’impossibilità di sottoporre a trigger il battito cardiaco fetale. La RM ha visualizzato segni diretti della patologia in 21 feti, indiretti in 6 ed entrambi in 15.

Conclusioni

Le sequenze SSFP permettono uno studio RM morfologico del distretto cardiovascolare mentre attualmente riescono ad aggiungere dati funzionali solamente in maniera subottimale.

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Authors and Affiliations

  1. Dipartimento di Scienze Radiologiche, “Sapienza” Università degli Studi di Roma, Policlinico Umberto I, Viale del Policlinico 155, 00161, Rome, Italy

    L. Manganaro, S. Savelli, M. Di Maurizio, A. Francioso, F. Fierro, A. Tomei, F. Coratella & L. Ballesio

  2. Dipartimento di Pediatria, Servizio di Cardiologia Pediatrica, “Sapienza” Università degli Studi di Roma, Policlinico Umberto I, Viale del Policlinico 155, 00161, Rome, Italy

    F. Ventriglia

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  1. L. Manganaro
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  2. S. Savelli
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  3. M. Di Maurizio
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  4. A. Francioso
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  5. F. Fierro
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  6. A. Tomei
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  7. F. Coratella
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  8. L. Ballesio
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  9. F. Ventriglia
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Corresponding author

Correspondence to S. Savelli.

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Manganaro, L., Savelli, S., Di Maurizio, M. et al. Fetal MRI of the cardiovascular system: role of steady-state free precession sequences for the evaluation of normal and pathological appearances. Radiol med 114, 852–870 (2009). https://doi.org/10.1007/s11547-009-0419-1

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  • DOI: https://doi.org/10.1007/s11547-009-0419-1

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