Neuroimaging and Cerebrovascular Changes in Fetuses with Complex Congenital Heart Disease
Abstract
:1. Introduction
2. Materials and Methods
- LSOL (left-sided obstructive lesions): HLHS, aortic stenosis, aortic arch hypoplasia or coarctation.
- RSOL (right-sided obstructive lesions): pulmonary atresia, tetralogy of Fallot, Ebstein’s anomaly, Tricuspid atresia, pulmonary stenosis.
- MTC (mixed type of CHD): double outlet right ventricle without pulmonary stenosis, single ventricle, truncus arteriosus, transposition of great arteries.
- Others (e.g., cardiomyopathy, tumors).
- Fetal echocardiography;
- Ultrasound evaluation;
- MRI of fetal brain;
- Genetic counseling;
- Amniocentesis.
2.1. Fetal Echocardiography
2.2. Ultrasound Evaluation
2.3. Magnetic Resonance Imaging
- T2-weighted HASTE: repetition time (TR) 1500 ms, echo time (TE) 151 ms; slices of 3 mm; FOV 260 × 350 mm; 256 × 256 matrices; time of acquisition (TA) 20 s.
- T1-weighted FLASH 2D: TR 362 ms; TE 4.8 ms; slices 5.5 mm; flip angle 70°; FOV 350 × 300 mm; 256 × 192 matrices; TA 25 to 30 s with and [29] without fat saturation.
- Diffusion weighted imaging: TR 8000 ms; TE 90 ms; inversion time 185 ms; slices of 5 mm; FOV 420 × 300 mm; 192 × 192 matrix; TA 45 s; 3 b-factor per floor: 0.200 and 700 mm2/s.
2.4. Genetic Counseling
2.5. Statistical Analysis
2.6. Ethical Approval
3. Results
3.1. Cerebroplacental Doppler Data
3.2. Brain Abnormalities
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Main Sample’s Characteristics | Mean ± SD |
---|---|
Age (years) | 33.6 (5.3) |
Gestational age at evaluation (weeks) | 31.7 (5.4) |
Type of CHD | n (%) |
LSOL | 11 (17.5) |
RSOL | 6 (9.5) |
MTC | 26 (41.3) |
Others | 20 (31.7) |
US Variables | LSOL Median (IQRSD) | RSOL Median (IQR) m SD | MTC Median (IQR) m SD | OTHERS Median (IQR) m SD | p-Value |
---|---|---|---|---|---|
UA-PI | 0.38 (2.29) | 0.87 (1.88) | −0.28 (2.09) | 0.15 (1.50) | 0.4076 |
MCA-PI | −0.78 (1.88) | 0.93 (1.68) | −0.33 (1.20) | 0.34 (1.24) | 0.036 |
CPR | −1.28 (1.66) | −0.26 (1.42) | −0.43 (1.73) | −0.08 (1.32) | 0.4343 |
HC | −1.36 (0.89) | −0.4 (0.80) | −0.81 (0.45) | −0.96 (1.00) | 0.0182 |
Fetal Brain Abnormalities | LSOL n (%) | RSOL n (%) | MTC n (%) | OTHERS n (%) | TOTAL n (%) |
---|---|---|---|---|---|
Supratentorial diameter | 0 | 1 (11.1) | 5 (55.6) | 3 (33.3) | 9 (14.3) |
Subtentorial diameter | 3 (37.5) | 1 (12.5) | 4 (50) | 0 | 8 (12.7) |
Corpus callosum | 5 (31.3) | 0 | 6 (37.5) | 5 (31.2) | 16 (25.4) |
Subarachnoid spaces | 0 | 1 (12.5) | 4 (50) | 3 (37.5) | 8 (12.7) |
Gyrification abnormalities | 2 (22.2) | 3 (33.4) | 4 (44.4) | 0 | 9 (14.3) |
Ventriculomegaly | 3 (23) | 0 | 6 (46.2) | 4 (30.8) | 13 (20.6) |
US Descriptors | No CNS Abnormalities m (SD) | CNS Abnormalities m (SD) | p-Value |
---|---|---|---|
HC | 307.8 (44) | 264 (49.5) | 0.003 |
UA-PI | 0.9 (0.18) | 1.07 (0.24) | 0.15 |
MCA-PI | 1.78 (0.32) | 1.72 (0.33) | 0.59 |
CPR | 1.88 (0.44) | 1.67 (0.47) | 0.13 |
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Vena, F.; Manganaro, L.; D’Ambrosio, V.; Masciullo, L.; Ventriglia, F.; Ercolani, G.; Bertolini, C.; Catalano, C.; Di Mascio, D.; D’Alberti, E.; et al. Neuroimaging and Cerebrovascular Changes in Fetuses with Complex Congenital Heart Disease. J. Clin. Med. 2022, 11, 6740. https://doi.org/10.3390/jcm11226740
Vena F, Manganaro L, D’Ambrosio V, Masciullo L, Ventriglia F, Ercolani G, Bertolini C, Catalano C, Di Mascio D, D’Alberti E, et al. Neuroimaging and Cerebrovascular Changes in Fetuses with Complex Congenital Heart Disease. Journal of Clinical Medicine. 2022; 11(22):6740. https://doi.org/10.3390/jcm11226740
Chicago/Turabian StyleVena, Flaminia, Lucia Manganaro, Valentina D’Ambrosio, Luisa Masciullo, Flavia Ventriglia, Giada Ercolani, Camilla Bertolini, Carlo Catalano, Daniele Di Mascio, Elena D’Alberti, and et al. 2022. "Neuroimaging and Cerebrovascular Changes in Fetuses with Complex Congenital Heart Disease" Journal of Clinical Medicine 11, no. 22: 6740. https://doi.org/10.3390/jcm11226740