title: An exploration of the potential utility of fetal cardiovascular MRI as an adjunct to fetal echocardiography.
abstract: OBJECTIVE
  Fetal cardiovascular magnetic resonance imaging (MRI) offers a potential alternative to echocardiography, although in practice, its use has been limited. We sought to explore the need for additional imaging in a tertiary fetal cardiology unit and the usefulness of standard MRI sequences.
  
  
  METHODS
  Cases where the diagnosis was not fully resolved using echocardiography were referred for MRI. Following a three-plane localiser, fetal movement was assessed with a balanced steady-state free precession (bSSFP) cine. Single-shot fast spin echo and bSSFP sequences were used for diagnostic imaging.
  
  
  RESULTS
  Twenty-two fetal cardiac MRIs were performed over 12 months, at mean gestation of 32 weeks (26-38 weeks). The majority of referrals were for suspected vascular abnormalities (17/22), particularly involving the aortic arch (n = 10) and pulmonary vessels (n = 4). Single-shot fast spin echo sequences produced 'black-blood' images, useful for examining the extracardiac vasculature in these cases. BSSFP sequences were more useful for intracardiac structures. Real-time SSFP allowed for dynamic assessment of structures such as cardiac masses, with enhancement patterns also allowing for tissue characterisation in these cases.
  
  
  CONCLUSIONS
  Fetal vascular abnormalities such as coarctation can be difficult to diagnose by using ultrasound. Fetal MRI may have an adjunctive role in the evaluation of the extracardiac vascular anatomy and tissue characterisation. © 2016 The Authors. Prenatal Diagnosis published by John Wiley & Sons, Ltd.
authors: Evelina Children's Hospital, London, UK. david.lloyd@kcl.ac.uk.|Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK. david.lloyd@kcl.ac.uk.
authors: David F A
authors: DF
authors: Lloyd
authors: Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK.
authors: Joshua F P
authors: JF
authors: van Amerom
authors: Evelina Children's Hospital, London, UK.|Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK.
authors: Kuberan
authors: K
authors: Pushparajah
authors: Evelina Children's Hospital, London, UK.
authors: John M
authors: JM
authors: Simpson
authors: Evelina Children's Hospital, London, UK.
authors: Vita
authors: V
authors: Zidere
authors: Evelina Children's Hospital, London, UK.
authors: Owen
authors: O
authors: Miller
authors: Evelina Children's Hospital, London, UK.
authors: Gurleen
authors: G
authors: Sharland
authors: Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK.
authors: Joanna
authors: J
authors: Allsop
authors: Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK.
authors: Matthew
authors: M
authors: Fox
authors: Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK.
authors: Maelene
authors: M
authors: Lohezic
authors: Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK.
authors: Maria
authors: M
authors: Murgasova
authors: Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK.
authors: Christina
authors: C
authors: Malamateniou
authors: Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK.
authors: Jo V
authors: JV
authors: Hajnal
authors: Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK.
authors: Mary
authors: M
authors: Rutherford
authors: Evelina Children's Hospital, London, UK.|Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK.
authors: Reza
authors: R
authors: Razavi
mesh_terms: D001013:Aorta, Thoracic / Q000002:abnormalities / Q000000981:diagnostic imaging; D001017:Aortic Coarctation / Q000000981:diagnostic imaging; D004240:Diverticulum / Q000000981:diagnostic imaging; D004452:Echocardiography / Q000379:methods*; D005260:Female; D005318:Fetal Heart / Q000002:abnormalities / Q000000981:diagnostic imaging*; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging*; D006345:Heart Septal Defects, Ventricular / Q000000981:diagnostic imaging; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011263:Pregnancy Trimester, Third; D011296:Prenatal Diagnosis; D011651:Pulmonary Artery / Q000002:abnormalities / Q000000981:diagnostic imaging; D011667:Pulmonary Veins / Q000002:abnormalities / Q000000981:diagnostic imaging; D016216:Ultrasonography, Prenatal