Sahar Saleem MD, Presenter: Nothing to Disclose

Rasha Kamel MBBCh,MD, Abstract Co-Author: Nothing to Disclose

Sherif N Negm MBBCh,MD, Abstract Co-Author: Nothing to Disclose

Mohamed Elsherif MBBCh,MSc, Abstract Co-Author: Nothing to Disclose

To study the role of MRI in evaluating cardiac and extracardiac findings in fetuses with congenital heart disease (CHD).

We studied with MRI 28 fetuses (26 singleton & 2 twins) sonographically diagnosed with CHD at an average gestational age of 26 weeks (SD6) to investigate the cardiac diagnosis and search for extracardiac anomalies. MRI was obtained along fetal body planes and cardiac axes using T1- & T2-weighted sequences. We analyzed fetal cardiac structures using a modified anatomical segmental approach for CHD. MRI findings were correlated with prenatal US and postnatal imaging/autoptic findings. 

Outcome measures confirmed 60 cardiac abnormalities in 28 fetuses and 44 extracardiac anomalies in 26 fetuses that involved CNS, urinary, liver/spleen, skeletal, and lungs. Cardiac pathologies included combination of atrioventricular septal defects (n=6), transposition of great arteries (n=2), Fallot tetralogy (n=2), Fallot pentalogy (n=2), aortic coarctation (n=1), hypoplastic left heart (n=3), hypoplastic right heart (n=1), situs inversus totalis (n=2), ectopia cordis (n=1), left atrial isomerism (n=1), single four-chamber heart in a dicephalus-tripus-bibrachius twin (n=1), eight-chamber heart in thoraco-pagus twin (n=1), aberrant left subclavian artery (n=1), left superior-vena-cava (LSVC) (n=1), Ebstein's (n=1), rhabdomyomas (n=3), double-outlet-right-ventricle (DORV) (n=2), anomalous pulmonary venous drainage (n=1), and pericardial effusion (n=6). In correlation with goldstandard measures, fetal MRI correctly showed cardiac anomalies in 20 fetuses (71.4%), missed some cardiac findings and identified others in 5 (17.9%), missed most cardiac lesions in 3 (10.7%). Fetal MRI correctly detected 38/44 (86.4%) extracardiac findings that helped to refine diagnosis of fetal sydnromes such as Fryns-Moerman, hydrolethalus, kashani, Cerebro-arthrodigital, and tuberous sclerosis.     

Fetal MRI has a promising complementary role in assessing cardiac pathologies diagnosed by US and in detecting associated extracardiac anomalies

In-utero MRI is a valuable tool in refining diagnosis of fetuses with CHD

Saleem, S, Kamel, R, Negm, S, Elsherif, M, Cardiac and Extra-Cardiac MRI Findings in Fetuses with Congenital Heart Abnormalities .  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11004252.html