E5087. Diagnosis of Fetal Congenital Heart Disease Using Prenatal Cardiac MRI
  1. Su-Zhen Dong; Department of Radiology, Shanghai Children's Medical Center, Shanghai Jiao Tong University, School of Medicine
Prenatal ECG is the main imaging method for diagnosing fetal congenital heart disease; however, prenatal ECG has some limitations. MRI offers several advantages over obstetric ultrasound when fetal position, rib calcification, maternal obesity, and oligohydramnios, particularly during the third trimester, interfere with ultrasound imaging. This exhibit will present the value of prenatal cardiac MRI (CMR) in diagnosing fetal congenital heart disease.

Educational Goals / Teaching Points
This educational lecture will review recent technical advances in fetal CMR and the modified anatomic segmental approach to image fetal congenital heart disease. It will further describe the imaging appearances of fetal normal cardiovascular structure and present fetal cases of various structural congenital heart disease diagnosed using prenatal MRI.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Imaging sequences include SSFP (2D and 3D), Cine SSFP, phase contrast (PC) Cine (flow quantification, hemodynamic assessment), T2 mapping (vessel oxygen saturation), single-shot turbo spin echo (SSTSE), and DWI (assess fetal brain with congenital heart disease); no sedatives, IV gadolinium-based contrast media. SSFP images are acquired in axial, four-chamber, short-axis, coronal and oblique sagittal views. Transverse view of the aortic arch and four chambers are two most important planes.

Fetal CMR can be a useful adjunct, particularly when ECG is limited (fetal position, rib calcification, maternal obesity, uterine myoma, and oligohydramnios).