Related Experiment Video
Updated: May 2, 2026
Fetal Mouse Cardiovascular Imaging Using a High-frequency Ultrasound 30/45MHZ System
Published on: May 5, 2018
Prevalence and spectrum of in utero structural brain abnormalities in fetuses with complex congenital heart disease
M Brossard-Racine1, A J du Plessis2, G Vezina3
1From the Advanced Pediatric Brain Imaging Research Laboratory (M.B.-R., I.E.E., D.F., C.L.)Division of Diagnostic Imaging and Radiology (M.B.-R., G.V., D.B., I.E.E., D.F., C.L.)Fetal and Transitional Medicine (M.B.-R., A.d.P., M.D., C.L.).
Insights
Brain abnormalities are common in fetuses with congenital heart disease (CHD). This study found 23% of fetuses with CHD had brain abnormalities, compared to only 1.5% in healthy controls.
Area of Science:
- Neonatal neurology
- Fetal imaging
- Congenital heart disease
Background:
- Brain injury is a significant complication for neonates with complex congenital heart disease (CHD).
- Fetuses with CHD may have an increased risk of brain abnormalities.
- Previous studies have not prospectively examined the nature and frequency of these abnormalities using conventional fetal MRI.
Purpose of the Study:
- To determine the prevalence and spectrum of brain abnormalities in fetuses with complex CHD using conventional fetal MRI.
- To compare the prevalence of brain abnormalities in fetuses with CHD to a control group of fetuses from healthy pregnancies.
Main Methods:
- Prospective recruitment of pregnant women with confirmed fetal CHD and healthy controls.
- Fetal MRI performed between 18 and 39 weeks of gestational age.
- Comparison of brain abnormality findings between the CHD cohort (144 fetuses) and the control group (194 fetuses).
Main Results:
- Brain abnormalities were detected in 23% of fetuses with CHD, versus 1.5% in controls (P < .001).
- The most frequent abnormalities in the CHD group were mild unilateral ventriculomegaly (36.4%) and increased extra-axial spaces (30.3%).
- No significant association was found between specific cardiac physiology and the type or frequency of brain abnormalities.
Conclusions:
- This is the first large prospective study to report conventional MRI findings in fetuses with CHD.
- Brain abnormalities are prevalent but generally mild in fetuses with CHD.
- Further research is needed to understand the long-term implications of these antenatal findings.
Background And Purpose:
Brain injury is a major complication in neonates with complex congenital heart disease. Preliminary evidence suggests that fetuses with congenital heart disease are at greater risk for brain abnormalities. However, the nature and frequency of these brain abnormalities detected by conventional fetal MR imaging has not been examined prospectively. Our primary objective was to determine the prevalence and spectrum of brain abnormalities detected on conventional clinical MR imaging in fetuses with complex congenital heart disease and, second, to compare the congenital heart disease cohort with a control group of fetuses from healthy pregnancies.
Materials And Methods:
We prospectively recruited pregnant women with a confirmed fetal congenital heart disease diagnosis and healthy volunteers with normal fetal echocardiogram findings who underwent a fetal MR imaging between 18 and 39 weeks gestational age.
Results:
A total of 338 fetuses (194 controls; 144 with congenital heart disease) were studied at a mean gestational age of 30.61 ± 4.67 weeks. Brain abnormalities were present in 23% of the congenital heart disease group compared with 1.5% in the control group (P < .001). The most common abnormalities in the congenital heart disease group were mild unilateral ventriculomegaly in 12/33 (36.4%) and increased extra-axial spaces in 10/33 (30.3%). Subgroup analyses comparing the type and frequency of brain abnormalities based on cardiac physiology did not reveal significant associations, suggesting that the brain abnormalities were not limited to those with the most severe congenital heart disease.
Conclusions:
This is the first large prospective study reporting conventional MR imaging findings in fetuses with congenital heart disease. Our results suggest that brain abnormalities are prevalent but relatively mild antenatally in fetuses with congenital heart disease. The long-term predictive value of these findings awaits further study.
Related Concept Videos
01:07Teratogenicity
01:14Fetal Circulation
Two umbilical arteries transport blood from the fetus to the placenta. At the placenta, the blood absorbs oxygen and nutrients while simultaneously eliminating waste products. This oxygen-enriched and nutrient-rich blood then returns to the fetus through one...
01:21Aneurysm II: Clinical Manifestations and Diagnostic Studies
01:29Cardiomyopathy III: Hypertrophic Cardiomyopathy
01:27Development of the Heart
As the embryo undergoes lateral folding, these paired tubes approach each other, merging into a single primitive heart...
01:20Imaging Studies for Cardiovascular System III: X-Ray
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...