The visualization of the foetal heart using MRI is complicated because of the small heart size, high heart rate, and foetal motion 4, 8. Unlike US imaging, foetal MRI is not significantly limited by maternal obesity, oligohydramnios, uterine myoma, twins, and foetal lie, all of which impair US visualization of the foetus 5, 6, 7. To date, there has been no clinical or experimental evidence that MRI has any adverse effects on the human foetus in the second or third trimester 3, 4. Foetal magnetic resonance imaging (MRI) examinations have become useful adjuncts to ultrasound (US) exams when US diagnosis is doubtful. Foetal cardiac examination has become a routine part of screening foetal ultrasound (US), and suspected cardiac anomalies will require more comprehensive evaluation using foetal echocardiography (Echo). Prenatal diagnosis of certain types of CHD, such as transposition of the great arteries (TGA), pulmonary atresia with intact ventricle septum (PA/IVS), hypoplastic left heart syndrome (HLHS), obstructive total anomalous pulmonary veins connection (TAPVC), and other severe CHDs has been associated with improved outcomes and decreased perioperative mortality 2.
Congenital heart disease (CHD) is the most common congenital anomaly and is the major cause of infant mortality 1. The foetal cardiovascular system is the most frequently affected among congenital pathologies. The results of the present study indicated that foetal cardiac MRI examinations can be a useful adjunct to foetal echocardiography when the technical limitations of echocardiography make it inadequate for diagnosis.
Among the 1,619 foetuses referred for cardiac MRI, 1,379 (85.2%) cases were followed up using postnatal imaging and/or surgery, 240 (14.8%), including three twins, had no follow-up confirmation because of pregnancy termination without autopsy or loss to follow-up. Foetal cardiac MRI was performed using two 1.5 T units. This retrospective review included 1,573 pregnant women referred for a foetal cardiac MRI because of technically limited Echo. The present study aimed to introduce our foetal cardiac MRI scanning technology and over 14-years of experience on the potential utility of foetal cardiac MRI examination as an adjunct to foetal technically inadequate echocardiography (Echo). Unlike ultrasound (US) imaging, foetal magnetic resonance imaging (MRI) is not significantly limited by maternal obesity, oligohydramnios, uterine myoma, twins, and foetal lie, which impair US visualization of the foetus.
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