Truncus arteriosus communis in a midtrimester fetus: comparison of prenatal ultrasound and MRI with postmortem MRI and autopsy.
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.
Mühler
Matthias R
MR
Department of Radiology, Charité, CCM, Schumannstrasse 20/21, 10117 Berlin, Germany. matthias.muehler@charite.de
Rake
Anett
A
Schwabe
Michael
M
Chaoui
Rabih
R
Heling
Kay-Sven
KS
Planke
Christiane
C
Lembcke
Alexander
A
Fischer
Thomas
T
Kivelitz
Dietmar
D
D000025:Abortion, Eugenic / Q000379:methods; D000328:Adult; D001344:Autopsy; D018618:Echocardiography, Doppler, Color / Q000379:methods; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis*; D006345:Heart Septal Defects, Ventricular / Q000150:complications / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008488:Medical Illustration; D011237:Predictive Value of Tests; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods*; D014339:Truncus Arteriosus, Persistent / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D016216:Ultrasonography, Prenatal