Association Between Fetal Myocardial Alterations and Congenital Heart Disease Based on Post-Mortem Myocardial MRI

iRadiology Pub Date : 2025-05-09 DOI:10.1002/ird3.70011

Weizeng Zheng, Xia Ying, Yuan Chen, Le Wang, Peiyue Jiang, Ying Jiang, Guohui Yan, Hong Wang, Yimin Zhou, Yun Liang, Yu Zou, Liqun Sun, Qiong Luo

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Abstract

Background

Congenital heart disease (CHD) results from abnormal heart development during fetal development, leading to life-threatening complications. This study aimed to evaluate the feasibility of applying myocardial parametric mapping in post-mortem magnetic resonance imaging and to examine differences in the left ventricular myocardium between fetuses with CHD and controls.

Methods

This prospective case–control study was conducted on 14 deceased fetuses with CHD (CHD group) and 24 fetuses without CHD (control group). Fetuses with CHD were further stratified into the cyanotic (n = 9) and non-cyanotic (n = 5) CHD groups. T1, T2, and proton density relaxation times of the left ventricular myocardium were calculated and compared using multiple-dynamic multiple-echo post-mortem magnetic resonance imaging technology.

Results

The myocardial T2 relaxation time was significantly different between the groups (p = 0.033), with no difference in T1 or proton density relaxation times between the groups. A one-way analysis of variance with Tukey's test showed that the mean cyanotic CHD group showed a longer myocardial T2 relaxation time than the control group (98.000 ± 13.143 vs. 83.542 ± 9.491 ms, p = 0.003). Additionally, the correlation coefficient in the CHD group was significantly different between the myocardial T2 relaxation time and peak systolic velocity of pulmonary artery on a fetal echocardiogram (r² = 0.681, p = 0.010).

Conclusions

These results suggest that using myocardial alterations in the T2 relaxation time may provide a accurate early warning for myocardial injury and enable noninvasive recognition of cardiac involvement in fetuses with CHD.

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基于死后心肌MRI的胎儿心肌改变与先天性心脏病的关系

先天性心脏病（CHD）是由胎儿发育过程中心脏发育异常引起的，可导致危及生命的并发症。本研究旨在探讨心肌参数定位在死后磁共振成像中应用的可行性，并探讨冠心病胎儿与对照组左心室心肌的差异。方法采用前瞻性病例对照研究，选取14例已死亡的冠心病胎儿（冠心病组）和24例未死亡的冠心病胎儿（对照组）。将合并冠心病的胎儿进一步分为紫绀型（n = 9）和非紫绀型（n = 5）冠心病组。采用多动态多回声死后磁共振成像技术计算并比较左心室心肌T1、T2、质子密度松弛时间。结果心肌T2舒张时间组间差异有统计学意义（p = 0.033）， T1、质子密度舒张时间组间差异无统计学意义（p = 0.033）。单因素方差分析显示，紫绀型冠心病组心肌T2舒张时间明显长于对照组（98.000±13.143 ms∶83.542±9.491 ms, p = 0.003）。冠心病组胎儿超声心动图心肌T2舒张时间与肺动脉收缩峰值速度的相关系数差异有统计学意义（r2 = 0.681, p = 0.010）。结论利用心肌T2舒张时间的变化可以准确预警冠心病胎儿心肌损伤，实现无创识别心脏受累。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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iRadiology

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