Dynamic fetal cardiovascular magnetic resonance imaging using Doppler ultrasound gating
(2018) In Journal of Cardiovascular Magnetic Resonance 20(1).- Abstract
Background: Fetal cardiovascular magnetic resonance (CMR) imaging may provide a valuable adjunct to fetal echocardiography in the evaluation of congenital cardiovascular pathologies. However, dynamic fetal CMR is difficult due to the lack of direct in-utero cardiac gating. The aim of this study was to investigate the effectiveness of a newly developed Doppler ultrasound (DUS) device in humans for fetal CMR gating. Methods: Fifteen fetuses (gestational age 30-39 weeks) were examined using 1.5 T CMR scanners at three different imaging sites. A newly developed CMR-compatible DUS device was used to generate gating signals from fetal cardiac motion. Gated dynamic balanced steady-state free precession images were acquired in 4-chamber and... (More)
Background: Fetal cardiovascular magnetic resonance (CMR) imaging may provide a valuable adjunct to fetal echocardiography in the evaluation of congenital cardiovascular pathologies. However, dynamic fetal CMR is difficult due to the lack of direct in-utero cardiac gating. The aim of this study was to investigate the effectiveness of a newly developed Doppler ultrasound (DUS) device in humans for fetal CMR gating. Methods: Fifteen fetuses (gestational age 30-39 weeks) were examined using 1.5 T CMR scanners at three different imaging sites. A newly developed CMR-compatible DUS device was used to generate gating signals from fetal cardiac motion. Gated dynamic balanced steady-state free precession images were acquired in 4-chamber and short-axis cardiac views. Gating signals during data acquisition were analyzed with respect to trigger variability and sensitivity. Image quality was assessed by measuring endocardial blurring (EB) and by image evaluation using a 4-point scale. Left ventricular (LV) volumetry was performed using the single-plane ellipsoid model. Results: Gating signals from the fetal heart were detected with a variability of 26 ± 22 ms and a sensitivity of trigger detection of 96 ± 4%. EB was 2.9 ± 0.6 pixels (4-chamber) and 2.5 ± 0.1 pixels (short axis). Image quality scores were 3.6 ± 0.6 (overall), 3.4 ± 0.7 (mitral valve), 3.4 ± 0.7 (foramen ovale), 3.6 ± 0.7 (atrial septum), 3.7 ± 0.5 (papillary muscles), 3.8 ± 0.4 (differentiation myocardium/lumen), 3.7 ± 0.5 (differentiation myocardium/lung), and 3.9 ± 0.4 (systolic myocardial thickening). Inter-observer agreement for the scores was moderate to very good (kappa 0.57-0.84) for all structures. LV volumetry revealed mean values of 2.8 ± 1.2 ml (end-diastolic volume), 0.9 ± 0.4 ml (end systolic volume), 1.9 ± 0.8 ml (stroke volume), and 69.1 ± 8.4% (ejection fraction). Conclusion: High-quality dynamic fetal CMR was successfully performed using a newly developed DUS device for direct fetal cardiac gating. This technique has the potential to improve the utility of fetal CMR in the evaluation of congenital pathologies.
(Less)
- author
- organization
- publishing date
- 2018-03-12
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Cardiac-gated imaging techniques, Cardiovascular magnetic resonance imaging, Cine MRI, Doppler ultrasound, Fetal heart
- in
- Journal of Cardiovascular Magnetic Resonance
- volume
- 20
- issue
- 1
- article number
- 17
- publisher
- BioMed Central (BMC)
- external identifiers
-
- scopus:85043571713
- pmid:29530064
- ISSN
- 1097-6647
- DOI
- 10.1186/s12968-018-0440-4
- language
- English
- LU publication?
- yes
- id
- c9f6e034-0b15-43f6-996e-ef5f7c10caf1
- date added to LUP
- 2018-03-29 10:55:17
- date last changed
- 2024-07-22 14:56:12
@article{c9f6e034-0b15-43f6-996e-ef5f7c10caf1, abstract = {{<p>Background: Fetal cardiovascular magnetic resonance (CMR) imaging may provide a valuable adjunct to fetal echocardiography in the evaluation of congenital cardiovascular pathologies. However, dynamic fetal CMR is difficult due to the lack of direct in-utero cardiac gating. The aim of this study was to investigate the effectiveness of a newly developed Doppler ultrasound (DUS) device in humans for fetal CMR gating. Methods: Fifteen fetuses (gestational age 30-39 weeks) were examined using 1.5 T CMR scanners at three different imaging sites. A newly developed CMR-compatible DUS device was used to generate gating signals from fetal cardiac motion. Gated dynamic balanced steady-state free precession images were acquired in 4-chamber and short-axis cardiac views. Gating signals during data acquisition were analyzed with respect to trigger variability and sensitivity. Image quality was assessed by measuring endocardial blurring (EB) and by image evaluation using a 4-point scale. Left ventricular (LV) volumetry was performed using the single-plane ellipsoid model. Results: Gating signals from the fetal heart were detected with a variability of 26 ± 22 ms and a sensitivity of trigger detection of 96 ± 4%. EB was 2.9 ± 0.6 pixels (4-chamber) and 2.5 ± 0.1 pixels (short axis). Image quality scores were 3.6 ± 0.6 (overall), 3.4 ± 0.7 (mitral valve), 3.4 ± 0.7 (foramen ovale), 3.6 ± 0.7 (atrial septum), 3.7 ± 0.5 (papillary muscles), 3.8 ± 0.4 (differentiation myocardium/lumen), 3.7 ± 0.5 (differentiation myocardium/lung), and 3.9 ± 0.4 (systolic myocardial thickening). Inter-observer agreement for the scores was moderate to very good (kappa 0.57-0.84) for all structures. LV volumetry revealed mean values of 2.8 ± 1.2 ml (end-diastolic volume), 0.9 ± 0.4 ml (end systolic volume), 1.9 ± 0.8 ml (stroke volume), and 69.1 ± 8.4% (ejection fraction). Conclusion: High-quality dynamic fetal CMR was successfully performed using a newly developed DUS device for direct fetal cardiac gating. This technique has the potential to improve the utility of fetal CMR in the evaluation of congenital pathologies.</p>}}, author = {{Kording, Fabian and Yamamura, Jin and De Sousa, Manuela Tavares and Ruprecht, Christian and Hedström, Erik and Aletras, Anthony H. and Ellen Grant, P. and Powell, Andrew J. and Fehrs, Kai and Adam, Gerhard and Kooijman, Hendrik and Schoennagel, Bjoern P.}}, issn = {{1097-6647}}, keywords = {{Cardiac-gated imaging techniques; Cardiovascular magnetic resonance imaging; Cine MRI; Doppler ultrasound; Fetal heart}}, language = {{eng}}, month = {{03}}, number = {{1}}, publisher = {{BioMed Central (BMC)}}, series = {{Journal of Cardiovascular Magnetic Resonance}}, title = {{Dynamic fetal cardiovascular magnetic resonance imaging using Doppler ultrasound gating}}, url = {{http://dx.doi.org/10.1186/s12968-018-0440-4}}, doi = {{10.1186/s12968-018-0440-4}}, volume = {{20}}, year = {{2018}}, }