Fetal mid-muscular ventricular septal defect: Role of fetal cardio-vascular evaluation with magnetic resonance (MR) imaging and MR-angiography

We report our experience with fetal cardiac MR imaging and fetal MR-angiography in a 35 + 5-week fetus with a ventricular septal defect (VSD). Case: A fetus with an abnormal four-chamber view at obstetric US and a VSD of the medio-muscular portion of the ventricular septum at echocardiography underwent MRI to assess possible associated anomalies. Gradient Echo (GE) sequences with steady-state free precession (TrueFISP) and cine-MR sequences demonstrated a 4 mm VSD involving the medio-muscular portion of the septum in a morphologically and volumetrically normal fetal heart with a correct origin of the great arteries. T1-weighted 3D spoiled sequences permitted to obtain angiographic images and MIP reconstructions that proved a normal size and position of the aorta disconfirming a suspected coartaction of the aorta. Conventional T2-weighted sequences excluded the presence of extracardiac abnormalities. A postnatal echocardiography, considered as standard of reference confirmed the VSD in an otherwise normal male newborn. © 2008 Elsevier Ireland Ltd. All rights reserved.