Skip to main content
2025 SCMR Conference Main banner
Final Program


Schedule at a Glance
Back

Quick Fire Cases

Quick Fire 4- Pediatric/Congenital Heart Disease VII

The role of cardiac magnetic resonance imaging during pregnancy - a challenging early diagnosis of a congenital heart condition (QF_SA_128)

Saturday, February 1, 2025
8:10 AM – 8:20 AM East Coast USA Time
Location: Blue Room PreFunction
Description of Clinical Presentation:

Congenital heart defects affect, approximately, 1% of the population and standard echocardiography can have limited diagnostic accuracy in certain cases. Fetal cardiac magnetic resonance (fCMR) has potential to clarify anatomic information, improving prenatal diagnosis and, thereby, future newborn medical follow-up. 

Diagnostic Techniques and Their Most Important Findings:

Case. A 28-year-old pregnant woman underwent routine prenatal examination, with evidence of left ventricle apical aneurysm on fetal echocardiogram. The fetus did not present other severe complications and was monitored with serial ultrasound examinations until the third trimester of pregnancy. Two weeks before delivery, the mother underwent an MRI for anatomical morphofunctional assessment (thoracic, neurological and cardiovascular) of her child. It has been successfully performed at 1.5 T (GE Voyager - body 70cm), uneventful for both. Our protocol consisted of anatomical balanced steady state free precession (bSSFP) images in the sagittal, transversal, and coronal planes; cardiac cine images in left ventricular short-axis stack and standard long-axis views (4-chamber, 3-chamber, and 2-chamber views; acquired spatial resolution of 1.4 × 1.4 × 4 mm3 and an acquired temporal resolution of 81 milliseconds per frame) and anatomical black blood images covering the heart of the fetus. Images were preferably acquired in free breathing to simplify the procedure for the pregnant woman. No serious problems were observed in the neurological or thoracic systems, however, the presence of dyskinesia and apical aneurysm of the left ventricle were confirmed. 

At birth, a new MRI was performed on the child, which confirmed dilation, myocardial thinning and apical dyskinesia, findings accompanied by hypokinesia and late gadolinium enhancement of mid-inferolateral segment of the left ventricle, even in the presence of preserved global left ventricular function. Treatment directed by the Cardiopediatrician was instituted; the child was discharged, gaining weight, without other complications.

Learning Points from this Case:

Discussion. Fetal CMR imaging can add clinically useful information, with potential to help clinical decision-making in challenging cases, including mode of delivery and early postnatal treatment. With further refinement and experience, fCMR in CHD demonstrate ongoing potential as a complementary imaging modality in the care of these patients.