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Prenatal diagnosis of fetal respiratory function: evaluation of fetal lung maturity using lung‐to‐liver signal intensity ratio at magnetic resonance imaging
Author(s) -
Oka Yasuko,
Rahman Mosfequr,
Sasakura Chihaya,
Waseda Tomoo,
Watanabe Yukio,
Fujii Ryota,
Makinoda Satoru
Publication year - 2014
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.4469
Subject(s) - medicine , fetus , magnetic resonance imaging , lung , gestational age , receiver operating characteristic , confidence interval , gestation , pregnancy , nuclear medicine , obstetrics , radiology , biology , genetics
Objective The purpose of this retrospective study is to determine the fetal lung‐to‐liver signal intensity ratio (LLSIR) on T2‐weighted images for the prediction of neonatal respiratory outcome. Methods One hundred ten fetuses who underwent magnetic resonance imaging (MRI) examination for various indications after 22 weeks of gestation participated in this study. LLSIR was measured as the ratio of signal intensities of the fetal lung and liver on T2‐weighted images at MRI. We examined the changes of the ratio with advancing gestation and the relations between LLSIR and the presence of the severe respiratory disorder (SRD) after birth. The best cut‐off value of the LLSIR to predict respiratory outcome after birth was calculated using receiver operating characteristic (ROC) curve analysis. Results Lung‐to‐liver signal intensity ratio correlated significantly with advancing gestational age ( R = 0.35, p < 0.001). The non‐SRD group had higher LLSIR compared with the SRD group (2.15 ± 0.30 vs. 1.53 ± 0.40, p < 0.001). ROC curve analysis showed that fetuses with an LLSIR < 2.00 were more likely to develop SRD [sensitivity: 100%, 95% confidence interval (CI): 52–100%; specificity: 73%, 95% CI 54–88%]. Conclusion The fetal LLSIR on T2‐weighted images is an accurate marker to diagnose the fetal lung maturity. © 2014 The Authors. Prenatal Diagnosis published by John Wiley & Sons, Ltd.