Dynamic imaging of the fetal heart using metric optimized gating

Purpose Advances in fetal cardiovascular magnetic resonance imaging have been limited by the absence of a reliable cardiac gating signal. The purpose of this work was to develop and validate metric-optimized gating (MOG) for cine imaging of the fetal heart. Theory and Methods Cine MR and electrocardiogram data were acquired in healthy adult volunteers for validation of the MOG method. Comparison of MOG and electrocardiogram reconstructions was performed based on the image quality for each method, and the difference between MOG and electrocardiogram trigger times. Fetal images were also acquired, their quality evaluated by experienced radiologists, and the theoretical error in the MOG trigger times were calculated. Results Excellent agreement between electrocardiogram and MOG reconstructions was observed. The experimental errors in adult MOG trigger times for all five volunteers were ± (7, 25, 17, 8, and 13) ms. Fetal images captured normal and diseased cardiac dynamics. Conclusion MOG for cine imaging of the fetal myocardium was developed and validated in adults. Using MOG, the first gated MR images of the human fetal myocardium were obtained. Small moving structures were visualized during radial contraction, thus capturing normal fetal cardiac wall motion and permitting assessment of cardiac function. Magn Reson Med 70:1598-1607, 2013. © 2013 Wiley Periodicals, Inc.