Fetal MRI correlates with postnatal CT angiogram assessment of pulmonary anatomy in tetralogy of Fallot with absent pulmonary valve

Congenit Heart Dis. 2014 Jul-Aug;9(4):E105-9. doi: 10.1111/chd.12091. Epub 2013 May 22.

Abstract

In tetralogy of Fallot with absent pulmonary valve, pulmonary stenosis and regurgitation results in significant pulmonary artery dilatation. Branch pulmonary artery dilatation often compresses the tracheobronchial tree, causing fluid trapping in fetal life and air trapping and/or atelectasis after birth. Prenatal diagnosis predicts poor prognosis, which depends on the degree of respiratory insufficiency from airway compromise and lung parenchymal disease after birth. Fetal magnetic resonance imaging (MRI) has been useful in evaluating the effects of congenital lung lesions on lung development and indicating severity of pulmonary hypoplasia. This report is the first demonstrating the utility of fetal MRI in tetralogy of Fallot/absent pulmonary valve patients, which predicted postnatal pulmonary artery size and visualized airway compression and lung parenchymal lesions. The distribution of lobar fluid trapping on fetal MRI correlated with air trapping on postnatal computed tomography angiogram.

Keywords: Absent Pulmonary Valve; Fetal MRI; Tetralogy of Fallot.

Publication types

  • Case Reports

MeSH terms

  • Airway Obstruction / diagnosis
  • Airway Obstruction / etiology
  • Dilatation, Pathologic
  • Female
  • Gestational Age
  • Humans
  • Lung / diagnostic imaging
  • Lung / pathology
  • Magnetic Resonance Imaging*
  • Male
  • Predictive Value of Tests
  • Prenatal Diagnosis / methods*
  • Pulmonary Artery / diagnostic imaging*
  • Pulmonary Artery / pathology*
  • Pulmonary Atelectasis / diagnosis
  • Pulmonary Atelectasis / etiology
  • Pulmonary Valve / abnormalities*
  • Retrospective Studies
  • Tetralogy of Fallot / complications
  • Tetralogy of Fallot / diagnosis*
  • Tetralogy of Fallot / diagnostic imaging
  • Tetralogy of Fallot / pathology
  • Tomography, X-Ray Computed*
  • Ultrasonography, Prenatal