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Fetal Magnetic Resonance Imaging for the Prenatal Assessment of the Extended Cardiovascular System by CASSEAL (Cardiovascular System Sonographic Evaluation Algorithm)

Coral Bravo, Yolanda Ruiz, Luis Ortiz, Teresa Álvarez, Francisco Gámez, Carlos Marín, Ricardo Pérez, Ángel Lancharro and Juan De León-Luis

Purpose: To compare axial view images obtained with fetal ultrasound (US) and magnetic resonance imaging (MRI) when applying the Cardiovascular System Sonographic Evaluation Algorithm (CASSEAL).
Materials and method: CASSEAL is an US algorithm consisting on the acquisition of 9 different axial views of the fetal abdomen and chest, from the umbilical vein to the subclavian arteries. It was designed for a thorough US assessment of the extended fetal cardiovascular system. Feasibility and reproducibility of CASSEAL have already been proven; however, its application in fetal MRI has yet to be established. A fetal MRI was performed to a 25 week-old fetus with ventriculomegaly (11 mm) in order to obtain the 9 axial views required by CASSEAL. Subsequently, a comparison between both imaging techniques was performed for each view.
Results: The comparison of the images obtained with these two imaging techniques showed a good correlation in the identification of cardiovascular anatomical structures.
Conclusion: CASSEAL US axial views can be obtained in fetal MRI and correlation between the 2 techniques is good. This finding suggests that MRI may be a useful complement to US in the assessment of fetal cardiovascular anomalies using the same views by which sonographers assess fetal cardiovascular structures.

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