Functional cardiac MRI in preterm and term newborns

Area of Science:

• Neonatal cardiology
• Cardiovascular imaging
• Pediatric research

Background:

• Assessing cardiac function and systemic perfusion in newborns is crucial for understanding circulatory development and failure.
• Echocardiography is the current standard but has limitations in reproducibility and comprehensiveness.

Purpose of the Study:

• To evaluate cardiac magnetic resonance imaging (MRI) for assessing ventricular function and systemic perfusion in preterm and term neonates.
• To compare cardiac MRI techniques with echocardiography.
• To establish initial reference data for neonatal cardiac MRI.

Main Methods:

• An observational study involving cardiac MRI and echocardiography in 108 newborn infants.
• Phase-contrast (PC) MRI was used to quantify flow volumes (left ventricular output, right ventricular output, superior vena cava, descending aorta).
• Three-dimensional models were also utilized for LVO assessment.

Main Results:

• Phase-contrast MRI demonstrated good reproducibility for flow measurements (e.g., LVO limits of agreement ±50.2 ml/kg/min).
• Flow volumes were higher in infants with lower gestational ages.
• Cardiac MRI provided more reproducible results compared to echocardiographic assessment of LVO (±108.9 ml/kg/min).

Conclusions:

• Cardiac MRI is a feasible and detailed method for assessing neonatal cardiac function and systemic perfusion.
• MRI offers superior data completeness and reproducibility compared to echocardiography.
• Functional cardiac MRI holds potential as a research tool for studying circulatory failure pathophysiology and guiding clinical practice in neonates.