human-fetal-blood-flow-quantification-with-magnetic-resonance-imaging

Human Fetal Blood Flow Quantification with Magnetic Resonance Imaging and Motion Compensation

Magnetic resonance imaging (MRI) is an important tool for the clinical assessment of cardiovascular morphology and heart function. It is also the ...

The Hospital for Sick Children

University of Toronto

Recent advances in cardiovascular magnetic resonance (CMR) imaging have facilitated CINE imaging of the fetal heart. In this work, a preliminary investigation of the utility of multislice CINE CMR for assessing fetal congenital heart disease is performed and compared with echocardiography.

Preliminary Experience Using Motion Compensated CINE Magnetic Resonance Imaging to Visualise Fetal Congenital Heart Disease.

Validating new techniques for fetal cardiovascular magnetic resonance (CMR) is challenging due to random fetal movement that precludes repeat measurements. Consequently, fetal CMR development has been largely performed using physical phantoms or postnatal volunteers. In this work, we present an open-source simulation designed to aid in the development and validation of new approaches for fetal CMR. Our approach, fetal extended Cardiac-Torso cardiovascular magnetic resonance imaging (Fetal XCMR), builds on established methods for simulating CMR acquisitions but is tailored toward the dynamic physiology of the fetal heart and body. We present comparisons between the Fetal XCMR phantom and data acquired in utero, resulting in image quality, anatomy, tissue signals and contrast.

Fetal XCMR: a numerical phantom for fetal cardiovascular magnetic resonance imaging.

Brain injury, impaired brain growth, and long-term neurodevelopmental problems are common in children with transposition of the great arteries. We sought to identify clinical risk factors for brain injury and poor brain growth in infants with transposition of the great arteries undergoing the arterial switch operation, and to examine their relationship with neurodevelopmental outcome.

Associations Between Age at Arterial Switch Operation, Brain Growth, and Development in Infants With Transposition of the Great Arteries.

To determine prevalence and risk factors for brain injury in infants with critical congenital heart disease (CHD) from 2 sites with different practice approaches who were scanned clinically.

Brain Injury in Infants with Critical Congenital Heart Disease: Insights from Two Clinical Cohorts with Different Practice Approaches.

Magnetic resonance imaging (MRI) is an appealing technology for fetal cardiovascular assessment. It can be used to visualize fetal cardiac and vascular anatomy, to quantify fetal blood flow, and to quantify fetal blood oxygen saturation and hematocrit. However, there are practical limitations to the use of conventional MRI for fetal cardiovascular assessment, including the small size and high heart rate of the human fetus, the lack of conventional cardiac gating methods to synchronize data acquisition, and the potential corruption of MRI data due to maternal respiration and unpredictable fetal movements. In this review, we discuss recent technical advances in accelerated imaging, image reconstruction, cardiac gating, and motion compensation that have enabled dynamic MRI of the fetal heart.

Fetal Cardiac MRI: A Review of Technical Advancements.

The aims of this study were to: i) determine the spectrum of brain injury and ii) compare brain volumes between pre- and postoperative brain MRI in the infants receiving extracorporeal membrane oxygenation compared with those who did not require extracorporeal membrane oxygenation.

Decreased Brain Volumes and Infants With Congenital Heart Disease Undergoing Venoarterial Extracorporeal Membrane Oxygenation.

Noonan syndrome is an autosomal dominant disorder secondary to RASopathies, which are caused by germ-line mutations in genes encoding components of the RAS mitogen-activated protein kinase pathway. RIT1 (OMIM *609591) was recently reported as a disease gene for Noonan syndrome.

Complicated ventricular arrhythmia and hematologic myeloproliferative disorder in RIT1-associated Noonan syndrome: Expanding the phenotype and review of the literature.

Phase contrast MRI in the great vessels is a potential clinical tool for managing fetal pathologies. One challenge is the uncontrollable fetal motion, potentially corrupting flow quantifications.

Fetal Flow Quantification in Great Vessels Using Motion-Corrected Radial Phase Contrast MRI: Comparison With Cartesian.

Fetal cardiovascular MRI is showing promise as a clinical diagnostic tool in the setting of congenital heart disease when the cardiac anatomy is unresolved by US or when complementary quantitative data on blood flow, oxygen saturation and hematocrit are required to aid in management. Compared with postnatal cardiovascular MRI, prenatal cardiovascular MRI still has some technical limitations. However, ongoing technical advances continue to improve the robustness and usability of fetal cardiovascular MRI. In this review, we provide an overview of the state of the art of fetal cardiovascular MRI and summarize the current focus of clinical application for this versatile technique.

Article	Year
Preliminary Experience Using Motion Compensated CINE Magnetic Resonance Imaging to Visualise Fetal Congenital Heart Disease. Circulation. Cardiovascular imaging\| PubMed ID: 30558501	2018
Fetal XCMR: a numerical phantom for fetal cardiovascular magnetic resonance imaging. Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance\| PubMed ID: 31118056	2019
Associations Between Age at Arterial Switch Operation, Brain Growth, and Development in Infants With Transposition of the Great Arteries. Circulation\| PubMed ID: 31132861	2019
Brain Injury in Infants with Critical Congenital Heart Disease: Insights from Two Clinical Cohorts with Different Practice Approaches. The Journal of pediatrics\| PubMed ID: 31451185	2019
Fetal Cardiac MRI: A Review of Technical Advancements. Topics in magnetic resonance imaging : TMRI\| PubMed ID: 31592990	2019
Decreased Brain Volumes and Infants With Congenital Heart Disease Undergoing Venoarterial Extracorporeal Membrane Oxygenation. Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies\| PubMed ID: 32195905	2020
Complicated ventricular arrhythmia and hematologic myeloproliferative disorder in RIT1-associated Noonan syndrome: Expanding the phenotype and review of the literature. Molecular genetics & genomic medicine\| PubMed ID: 32396283	2020
Fetal Flow Quantification in Great Vessels Using Motion-Corrected Radial Phase Contrast MRI: Comparison With Cartesian. Journal of magnetic resonance imaging : JMRI\| PubMed ID: 32815242	2020
Fetal cardiovascular magnetic resonance imaging. Pediatric radiology\| PubMed ID: 33252756	2020

Davide Marini

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