Feasibility of fetal cardiac output measurement by phase-contrast magnetic resonance imaging using Doppler ultrasound gating increases with gestational age
ABSTRACT: Background: Fetal cardiovascular magnetic resonance (CMR) is a valuable tool for assessing fetal blood flow; however, its use has primarily been focused on near-term pregnancies. This study aimed to evaluate the feasibility of Doppler ultrasound-gated two-dimensional (2D) phase-contrast C...
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Elsevier
2025-01-01
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| Series: | Journal of Cardiovascular Magnetic Resonance |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1097664725000547 |
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| author | Signe Gade Hellmuth Ditte Staub Jørgensen Kasper Gadsbøll Caroline Taksøe-Vester Ann Tabor Olav Bjørn Petersen Niels Vejlstrup |
| author_facet | Signe Gade Hellmuth Ditte Staub Jørgensen Kasper Gadsbøll Caroline Taksøe-Vester Ann Tabor Olav Bjørn Petersen Niels Vejlstrup |
| author_sort | Signe Gade Hellmuth |
| collection | DOAJ |
| description | ABSTRACT: Background: Fetal cardiovascular magnetic resonance (CMR) is a valuable tool for assessing fetal blood flow; however, its use has primarily been focused on near-term pregnancies. This study aimed to evaluate the feasibility of Doppler ultrasound-gated two-dimensional (2D) phase-contrast CMR of the human fetus in the early, mid, and late third trimester. Methods: A total of 100 fetal MRI scans were performed at gestational age (GA) 28, 32, and 38 weeks in 38 fetuses with (n = 13) and without (n = 25) congenital heart defects. Combined ventricular output was measured by Doppler ultrasound-gated 2D phase-contrast CMR in the ascending aorta and main pulmonary artery. Success rate of acquisition, repeatability of phase-contrast measurements, and intra-/interobserver agreement were assessed at each GA. Results: Combined ventricular output was obtained in 76/100 (76%) scans. The success rate of acquisition improved with increasing GA from 15/34 (44%) at GA 28 weeks to 31/35 (89%) at GA 32 weeks (p < 0.001 compared to 28 weeks) and 30/31 (97%) at GA 38 weeks (p < 0.001 compared to 28 weeks). Repeatability of phase-contrast measurements demonstrated a moderate to strong correlation (r = 0.63–0.82, p = 0.002), with no significant bias but wide limits of agreement. The mean difference ±95% limits of agreement were 7.3 ± 245 mL/min, −13.0 ± 260 mL/min, and −3.9 ± 326 mL/min at 28, 32, and 38 weeks, respectively. Conclusion: Feasibility of fetal CMR improves with increasing GA. While Doppler-gated 2D phase-contrast CMR can effectively assess fetal combined ventricular output and allows for in-group comparisons, the precision may still be insufficient for clinical application. |
| format | Article |
| id | doaj-art-1e4f430e5800400f8b4ecf8524cd3b3c |
| institution | OA Journals |
| issn | 1097-6647 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Cardiovascular Magnetic Resonance |
| spelling | doaj-art-1e4f430e5800400f8b4ecf8524cd3b3c2025-08-20T02:36:16ZengElsevierJournal of Cardiovascular Magnetic Resonance1097-66472025-01-0127210189210.1016/j.jocmr.2025.101892Feasibility of fetal cardiac output measurement by phase-contrast magnetic resonance imaging using Doppler ultrasound gating increases with gestational ageSigne Gade Hellmuth0Ditte Staub Jørgensen1Kasper Gadsbøll2Caroline Taksøe-Vester3Ann Tabor4Olav Bjørn Petersen5Niels Vejlstrup6Center of Fetal Medicine, Department of Gynecology, Fertility, and Obstetrics, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark; Corresponding author.Center of Fetal Medicine, Department of Gynecology, Fertility, and Obstetrics, Copenhagen University Hospital - Rigshospitalet, Copenhagen, DenmarkCenter of Fetal Medicine, Department of Gynecology, Fertility, and Obstetrics, Copenhagen University Hospital - Rigshospitalet, Copenhagen, DenmarkCenter of Fetal Medicine, Department of Gynecology, Fertility, and Obstetrics, Copenhagen University Hospital - Rigshospitalet, Copenhagen, DenmarkCenter of Fetal Medicine, Department of Gynecology, Fertility, and Obstetrics, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, DenmarkCenter of Fetal Medicine, Department of Gynecology, Fertility, and Obstetrics, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, DenmarkDepartment of Cardiology, The Heart Centre, Copenhagen University Hospital - Rigshospitalet, Copenhagen, DenmarkABSTRACT: Background: Fetal cardiovascular magnetic resonance (CMR) is a valuable tool for assessing fetal blood flow; however, its use has primarily been focused on near-term pregnancies. This study aimed to evaluate the feasibility of Doppler ultrasound-gated two-dimensional (2D) phase-contrast CMR of the human fetus in the early, mid, and late third trimester. Methods: A total of 100 fetal MRI scans were performed at gestational age (GA) 28, 32, and 38 weeks in 38 fetuses with (n = 13) and without (n = 25) congenital heart defects. Combined ventricular output was measured by Doppler ultrasound-gated 2D phase-contrast CMR in the ascending aorta and main pulmonary artery. Success rate of acquisition, repeatability of phase-contrast measurements, and intra-/interobserver agreement were assessed at each GA. Results: Combined ventricular output was obtained in 76/100 (76%) scans. The success rate of acquisition improved with increasing GA from 15/34 (44%) at GA 28 weeks to 31/35 (89%) at GA 32 weeks (p < 0.001 compared to 28 weeks) and 30/31 (97%) at GA 38 weeks (p < 0.001 compared to 28 weeks). Repeatability of phase-contrast measurements demonstrated a moderate to strong correlation (r = 0.63–0.82, p = 0.002), with no significant bias but wide limits of agreement. The mean difference ±95% limits of agreement were 7.3 ± 245 mL/min, −13.0 ± 260 mL/min, and −3.9 ± 326 mL/min at 28, 32, and 38 weeks, respectively. Conclusion: Feasibility of fetal CMR improves with increasing GA. While Doppler-gated 2D phase-contrast CMR can effectively assess fetal combined ventricular output and allows for in-group comparisons, the precision may still be insufficient for clinical application.http://www.sciencedirect.com/science/article/pii/S1097664725000547Fetal MRIFetal cardiac outputCongenital heart defectsPrenatal diagnosisFeasibility study |
| spellingShingle | Signe Gade Hellmuth Ditte Staub Jørgensen Kasper Gadsbøll Caroline Taksøe-Vester Ann Tabor Olav Bjørn Petersen Niels Vejlstrup Feasibility of fetal cardiac output measurement by phase-contrast magnetic resonance imaging using Doppler ultrasound gating increases with gestational age Journal of Cardiovascular Magnetic Resonance Fetal MRI Fetal cardiac output Congenital heart defects Prenatal diagnosis Feasibility study |
| title | Feasibility of fetal cardiac output measurement by phase-contrast magnetic resonance imaging using Doppler ultrasound gating increases with gestational age |
| title_full | Feasibility of fetal cardiac output measurement by phase-contrast magnetic resonance imaging using Doppler ultrasound gating increases with gestational age |
| title_fullStr | Feasibility of fetal cardiac output measurement by phase-contrast magnetic resonance imaging using Doppler ultrasound gating increases with gestational age |
| title_full_unstemmed | Feasibility of fetal cardiac output measurement by phase-contrast magnetic resonance imaging using Doppler ultrasound gating increases with gestational age |
| title_short | Feasibility of fetal cardiac output measurement by phase-contrast magnetic resonance imaging using Doppler ultrasound gating increases with gestational age |
| title_sort | feasibility of fetal cardiac output measurement by phase contrast magnetic resonance imaging using doppler ultrasound gating increases with gestational age |
| topic | Fetal MRI Fetal cardiac output Congenital heart defects Prenatal diagnosis Feasibility study |
| url | http://www.sciencedirect.com/science/article/pii/S1097664725000547 |
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