Standardized Acquisition of Fetal Cardiac Cine MRI: A Practical Guide

Area of Science:

• Medical Imaging
• Cardiology
• Prenatal Diagnosis

Background:

• Fetal ultrasound is standard but limited by maternal and fetal factors.
• Fetal cardiac MRI was previously hindered by gating and motion compensation challenges.

Purpose of the Study:

• To propose a standardized framework for fetal cardiac cine MRI acquisition and interpretation.
• To integrate MRI into multimodality prenatal imaging strategies.

Main Methods:

• Developed a practical framework for fetal cardiac cine MRI using a segmental approach.
• Incorporated ungated T2-weighted imaging with slice-to-volume reconstruction for vascular assessment.
• Utilized retrospective gating enabled by advances in fetal cardiac rhythm monitoring.

Main Results:

• The proposed framework allows for systematic cardiac assessment consistent with fetal echocardiography.
• Demonstrated MRI's utility in assessing extracardiac vascular anatomy.
• Illustrated integration into multimodality prenatal imaging with representative cases.

Conclusions:

• A standardized fetal cardiac MRI protocol can enhance reproducibility across institutions.
• Fetal cardiac MRI can serve as a valuable complementary tool in prenatal cardiac evaluation.