title: Magnetic resonance imaging in the normal fetal heart and in congenital heart disease.
abstract: OBJECTIVE
  To evaluate prospectively the feasibility of magnetic resonance imaging (MRI) for assessment of the fetal heart for congenital heart disease (CHD).
  
  
  METHODS
  This was a cross-sectional study, including 66 fetuses with a normal heart and 40 with CHD. The fetal heart was examined on MRI using axial steady-state free precession (SSFP) sequences. Regression analysis was used to investigate the effect on the ability to visualize cardiac anatomy of gestational age at examination, maternal body mass index, presence of fetal cardiac abnormality, fetal movements, fetal lie and twinning. The sensitivity and specificity of detecting cardiac defects were calculated.
  
  
  RESULTS
  The four-chamber view was visualized in 98.1% of fetuses. The sensitivity of detecting a cardiac defect on the four-chamber view was 88% and the specificity 96%. The ability to visualize the left and right outflow tracts was only influenced by the presence of fetal movements: for the left outflow tract 94.4 vs. 50.0% visualization and for the right outflow tract 92.6 vs. 53.8% visualization without and with fetal movements, respectively. The sensitivity of detecting a cardiac defect of the left outflow tract was 63% and the specificity 100%, while sensitivity and specificity were 59 and 97%, respectively, for the right outflow tract.
  
  
  CONCLUSIONS
  Despite the use of SSFP sequences, MRI in the fetal heart remains of limited value. It can only be used as a second-line approach for abnormalities of the four-chamber view suspected at prenatal ultrasound.
authors.affiliation: Department of Obstetrics and Gynaecology, University Hospital Brugmann, Brussels, Belgium.
authors.forename: C
authors.initials: C
authors.lastname: Votino
authors.forename: J
authors.initials: J
authors.lastname: Jani
authors.forename: N
authors.initials: N
authors.lastname: Damry
authors.forename: H
authors.initials: H
authors.lastname: Dessy
authors.forename: X
authors.initials: X
authors.lastname: Kang
authors.forename: T
authors.initials: T
authors.lastname: Cos
authors.forename: L
authors.initials: L
authors.lastname: Divano
authors.forename: W
authors.initials: W
authors.lastname: Foulon
authors.forename: J
authors.initials: J
authors.lastname: De Mey
authors.forename: M
authors.initials: M
authors.lastname: Cannie
mesh_terms: D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005260:Female; D005318:Fetal Heart / Q000033:anatomy & histology* / Q000473:pathology* / Q000503:physiopathology; D005865:Gestational Age; D006330:Heart Defects, Congenital / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D015588:Observer Variation; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011296:Prenatal Diagnosis; D011446:Prospective Studies; D012680:Sensitivity and Specificity