December 12, 2021
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The research and the editorial authors report no relevant financial disclosures.
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Extracardiac abnormalities, including structural brain abnormalities, were commonly detected on fetal MRI in fetuses with various forms of congenital heart disease, researchers reported.
The extracardiac anomalies and structural brain anomalies were discovered as early as early pregnancy, Gregor O. Dovjak, MD, PhD, of the Department of Biomedical Imaging and Image-guided Therapy, Department of Neuroradiology and Musculoskeletal Radiology, Medical University of Vienna, and colleagues wrote.
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The researchers analyzed 429 consecutive fetuses with congenital heart disease who underwent MRI between 17 and 38 weeks gestation to determine the rate of extracardiac and structural brain abnormalities for each type of congenital heart disease.
Of the cohort, 56.6% had extracardiac abnormalities and 25.4% had structural brain abnormalities on MRI, Dovjak and colleagues wrote, adding that of the 191 fetuses who had normal genetic testing, 54.5% had extracardiac abnormalities and 19.4 % had structural brain abnormalities on MRI .
Other common extracardiac anomalies in the cohort were extrafetal anomalies (21.2%) and genitourinary anomalies (10.7%), the researchers said.
The most common structural brain abnormalities were hindbrain and midbrain abnormalities (11%), dorsal prosencephalon development (10%) and abnormal cerebrospinal fluid spaces (10.5%), the researchers wrote.
Detection rates of extracardiac anomalies did not differ significantly before 25 weeks (45.7%) or 25 weeks or later (54.3%).
Rates of extracardiac anomalies were high in all 15 categories of congenital heart disease studied, Dovjak and colleagues wrote.
“Since the overall outcome in congenital heart disease is highly dependent on the presence and severity of additional abnormalities, such as structural brain abnormalities and renal abnormalities, accurate prenatal diagnosis using fetal imaging modalities is essential in all types of congenital heart disease,” Dovjak and colleagues wrote. .
Lisa K. Hornberger
In a related editorial, Lisa K. Hornberger, MD, professor of pediatrics and adjunct professor of obstetrics and gynecology at Stollery Children’s Hospital, University of Alberta, Canada, and Angela McBrien, MB, BCH, MD, assistant professor of pediatrics at the University of Alberta, wrote: “The field of fetal cardiology is constantly expanding and offers a unique insight into the evolution of congenital heart disease and associated non-cardiac pathology. Further exploration of fetal congenital heart disease and extracardiac anomalies in this era of advanced genetic testing will no doubt elucidate the genetic underpinnings for many with multiple congenital anomalies or associations.In addition, longitudinal research will further our understanding of the relationship between congenital heart disease and extracardiac abnormalities, including structural brain abnormalities, and their impact on long-term clinical outcomes, including neurodevelopmental outcomes, these data are important to understand the role of fetal MRI in the diagnostic evaluation of fetal congenital heart disease and will ultimately inform our guidance and care for affected pregnant women. refine chapping further.”
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