Potential role of fetal cardiac evaluation with magnetic resonance imaging: preliminary experience

Objective To report our experience with magnetic resonance imaging (MRI) in fetal heart evaluation. Method Two radiologists examined 31 MRI of fetuses with no ultrasound (US) evidence of cardio-thoracic anomalies. T2-weighted half-Fourier single-shot turbo spin–echo sequences were acquired for anatomic evaluation; fast imaging with steady-state free precession (TrueFISP) and cine-MR sequences with real-time steady-state free precession oriented like standard fetal echocardiographic projections were acquired for the characterization of cardiovascular morphology and function. Results In every case, MRI assessed the viscero-atrial situs. The four-chamber view and the short-axis view of the left ventricle were obtained in all fetuses, the long-axis view of the aortic arch in 28, the long-axis view of the ductus arteriosus in 17, the five-chamber view in 12, the long-axis of the left ventricle in 9, the three-vessel view in 7, the tricuspid-aortic view in 3, and the transverse view of the aortic arch and the angulated view of the arch and the ductus arteriosus simultaneously in 2 fetuses. Conclusion Our preliminary experience demonstrates the feasibility to visualize the fetal heart with routine fetal MRI protocols in particular, by means of acquisition of TrueFISP imaging (morphological study) and real-time cine-MRI (dynamic study), potentially making MRI a second-level tool to add to fetal echocardiography in the prenatal study of congenital cardiac malformations. Copyright © 2008 John Wiley & Sons, Ltd.