Abstract
This study aimed to evaluate the diagnostic accuracy of fetal magnetic resonance imaging (MRI) for persistent left superior vena cava (LSVC). Prenatal echocardiography (echo) and/or ultrasound (US) and MRI data for 49 fetuses with persistent LSVC, confirmed via postnatal diagnoses between January 2010 and October 2015, were retrospectively reviewed. All prenatal MRI was performed at 1.5 T. Imaging sequences included steady-state free-precession (SSFP), single-shot turbo spin echo (SSTSE), and other sequences. All 49 cases of fetal persistent LSVC were correctly diagnosed via MRI, but only 34 cases (69.4%) were correctly diagnosed via an initial US and/or echo before MRI. Of the 15 cases that were not correctly diagnosed via US and/or echo, 8 had congenital heart diseases (CHDs) and 7 were without CHDs; however, they were associated with extracardiac abnormalities or maternal obesity. Thirty-five cases were associated with other cardiovascular abnormalities; 8, with extracardiac abnormalities; and 6, with no associated condition. In 44 (89.8%) cases, the innominate veins were absent; the remaining cases had innominate veins. In 14.3% of patients (7 cases), the persistent LSVC drained directly into the atrium. Fetal MRI can detect persistent LSVC and play an adjunctive role along with US in the evaluation of persistent LSVC.
Highlights
Persistence of thepersistent left superior vena cava (LSVC) is a common anomaly of the cardinal systemic venous drainage system
49 fetuses with persistent LSVC confirmed via postnatal imaging or operation or necropsy reports were evaluated using fetal echocardiography and fetal cardiovascular magnetic resonance (CMR) in our hospital
Termination of pregnancy was chosen by the parents in other 9 cases where persistent LSVC could not be confirmed by necropsy, and these cases were not included in this study
Summary
Persistence of thepersistent left superior vena cava (LSVC) is a common anomaly of the cardinal systemic venous drainage system. Persistent LSVC can occur in isolation or may be associated with other congenital heart diseases (CHDs). A prenatal diagnosis of persistent LSVC is sometimes helpful because it may be associated with cardiac and extra-cardiac diseases with an incidence rate as high as 83% and 48%, respectively[1, 2]. Prenatal US is the first choice to visualize fetal persistent LSVC. Several studies have documented the potential of MRI in diagnosing congenital heart defects[6,7,8,9,10,11] and vascular abnormalities[12, 13], the application of prenatal MRI to persistent LSVC has, to the best of our knowledge, not yet been reported
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