Fetal heart MRI

Motion correction and super-resolution methods for fetal MRI were designed for fetal brain undergoing rigid motion. But we have discovered that it can also be applied to upper fetal body because its movement is constrained by the rib-cage and fetus rarely performs breathing motion. This discovery led to new capability to confidently diagnose congenital abnormalities of fetal cardiac vasculature which are notoriously difficult to diagnose using ultrasound or motion corrupted MRI. This work was published in Lancet by our clinical collaborators and is incorporated into fetal cardiac service in St Thomas hospital in London.

Fetal heart is beating very fast (150 beats per minute) and this is a big challenge for MRI because it takes a second to acquire each slice and in this time the fetal heart already went through 2 or 3 full cardiac cycles. With the method above we can only see the anatomy averaged over the cardiac cycle. Our MR physics colleagues worked out a sequence that not only allows to reconstruct the beating fetal heart but also to measure the velocity of cardiac blood flow. This very new MR imaging technique can potentially turn out to be extremely valuable in more detailed diagnosis for congenital heart disease. These sequences are really complicated and also require quite sofisticated reconstruction. We gave our physicist a hand with this aspect and here is the result:

Relevant publications:

Fetal whole heart blood flow imaging using 4D cine MRI. Roberts, T. A., van Amerom, J. F. P., Uus, A., Lloyd, D. F. A., van Poppel, M. P. M., Price, A. N., Tournier, J-D., Mohanadass, C. A., Jackson, L. H., Malik, S. J., Pushparajah, K., Rutherford, M. A., Rezavi, R., Deprez, M. & Hajnal, J. V. Nature Communications 2020. Open access.

Three-dimensional visualisation of the fetal heart using prenatal MRI with motion-corrected slice-volume registration: a prospective, single-centre cohort study. David F A Lloyd, Kuberan Pushparajah, John M Simpson, Joshua F P van Amerom, Milou P M van Poppel, Alexander Schulz, Bernard Kainz, Maria Deprez, Maelene Lohezic, Joanna Allsop, Sujeev Mathur, Hannah Bellsham-Revell, Trisha Vigneswaran, Marietta Charakida, Owen Miller, Vita Zidere, Gurleen Sharland, Mary Rutherford, Joseph V Hajnal, Reza Razavi. The Lancet, Volume 393, Issue 10181, 2019, Pages 1619-1627. open access

Fetal whole‐heart 4D imaging using motion‐corrected multi‐planar real‐time MRI. van Amerom, JFP, Lloyd, DFA, Deprez, M, et al. Magn Reson Med. 2019; 82: 1055– 1072. pdf

Fetal whole-heart 4D flow cine MRI using multiple non-coplanar balanced SSFP stacks. Roberts, T. A., van Amerom, J. F. P., Uus, A., Lloyd, D. F. A., Price, A. N., Tournier, J-D., Jackson, L. H., Malik, S. J., van Poppel, M. P. M, Pushparajah, K., Rutherford, M. A., Razavi, R., Deprez, M., Hajnal, J. V. bioRxiv 2019. pdf