In order to employ clinically proven cardiac imaging methods in conjunction with an immediate image reconstruction, a direct gating method is necessary. 12– 14 Although post-processing methods are capable of producing a good image quality, their time-consuming image reconstruction in combination with fetal movement represents a crucial disadvantage and prevents the possibility to adapt imaging planes in real time. ![]() 11 However, the ECG cannot be applied for fetal cardiac MRI and several methods were developed to assign the acquired image data to the correct cardiac cycle using retrospective image reconstruction based on post-processing techniques. 3 One of the main challenges for high-quality fetal cardiac images using conventional cine reconstruction methods is accurate synchronization of the cardiac cycle with the MRI data acquisition, 10 usually achieved using the spatial information of an electrocardiogram (ECG). 8 Fetal cardiovascular magnetic resonance (CMR) may be especially helpful for the detection of duct-dependent lesions, such as coarctation of the aorta 9 and to recognize CHD in late gestation. 3 Fetal cardiac MRI may provide a valuable adjunct to fetal echocardiography as it provides the ability to image the fetal heart with excellent tissue contrast in arbitrary planes independent of the above-mentioned limitations of fetal echocardiography. 6įetal MRI is increasingly used as a second-line imaging tool for prenatal evaluation of the fetal brain 7 and other organs including the fetal heart. ![]() 5 Moreover, discordances of up to 29% between pre- and post-natal diagnoses of CHD and a limited ability to measure blood flow using echocardiography encourages the development of new techniques to improve prenatal cardiovascular imaging. Prenatal detection of CHD using echocardiography varies widely from 13% to 82%. 1, 2 However, fetal echocardiography is occasionally limited by the acoustic window, fetal position, maternal adipose tissue, gestational age, abdominal wall scars, and the level of training of the operator. ![]() The imaging modality of choice for prenatal diagnosis of congenital heart disease (CHD) is due to its ease of use, high availability, and high diagnostic accuracy fetal echocardiography.
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