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Diffusion‐weighted MRI in lungs of normal fetuses and those with congenital diaphragmatic hernia
Author(s) -
Cannie M.,
Jani J.,
De Keyzer F.,
Roebben I.,
Dymarkowski S.,
Deprest J.
Publication year - 2009
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1002/uog.7326
Subject(s) - medicine , diaphragmatic hernia , congenital diaphragmatic hernia , diaphragmatic breathing , fetus , hernia , diffusion mri , radiology , anatomy , magnetic resonance imaging , pathology , pregnancy , genetics , alternative medicine , biology
Objective To prospectively determine apparent diffusion coefficient (ADC) values of normally developing fetal lungs over gestation, as obtained by diffusion‐weighted (DW) magnetic resonance imaging (MRI) and to investigate its potential application in fetuses with congenital diaphragmatic hernia (CDH). Methods Informed consent was obtained for this cross‐sectional study of 93 fetuses with normal lungs and 14 with isolated left‐sided CDH, assessed between 18 and 40 weeks of gestation. MRI delineation of left and right lungs was performed on the native DW image, b0, and three values of ADC, corresponding to the overall value (ADC avg ), and values for low and high values of b (ADC low and ADC high , respectively) were calculated. Regression analysis was used to assess the relationship between gestational age and b0‐values as well as calculated ADC values. The b0 and ADC values of normal and CDH fetuses were compared with normal ranges using the Mann–Whitney U ‐test. Results In fetuses with normal lungs, there was a negative correlation between gestational age and b0 values as well as with ADC high , a positive correlation with ADC low but no correlation with ADC avg . When measurable, ADC high values were lower in CDH as compared to fetuses with normal lungs and ADC low values were higher. ADC low was unrelated to lung volume. Conclusions There is a significant relationship between ADC low and ADC high values and gestational age in normal fetal lungs. This relationship is most probably explained by developmental changes during the last three stages of lung development, which involve intense peripheral growth of airways and vessels as well as maturation. In CDH, measurement of ADC low might be useful as a predictor of postnatal outcome that is independent of lung volume. Copyright © 2009 ISUOG. Published by John Wiley & Sons, Ltd.