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Perinatal magnetic resonance fetal lung volumetry and fetal lung‐to‐liver signal intensity ratio for predicting short outcome in isolated congenital diaphragmatic hernia and cystic adenomatoid malformation of the lung
Author(s) -
Matsushita Mitsuru,
Ishii Keisuke,
Tamura Masaki,
Takahashi Yasuhiro,
Kamura Takeshi,
Takakuwa Koichi,
Tanaka Kenichi
Publication year - 2008
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/j.1447-0756.2008.00754.x
Subject(s) - medicine , pulmonary hypoplasia , congenital diaphragmatic hernia , fetus , lung , magnetic resonance imaging , hypoplasia , lung volumes , scimitar syndrome , diaphragmatic hernia , gestational age , prenatal diagnosis , nuclear medicine , pregnancy , radiology , hernia , biology , genetics
Abstract Aim: To evaluate the usefulness of magnetic resonance imaging (MRI) in predicting the risk of lethal pulmonary hypoplasia in fetuses. Methods: The subjects consisted of 15 fetuses (29–40 weeks' gestation), including fetuses with major malformation diagnosed on prenatal ultrasonography. MRI using a 1.5 T magnet and half‐Fourier acquisition single‐shot fast spin‐echo sequences were applied to all fetuses at 29–36 weeks. Fetal lung‐to‐liver signal intensity ratio (LLSIR) was calculated by medians of region‐of‐interest analysis; estimated fetal bodyweight (FBW), by ultrasonography; and estimated fetal lung volume (FLV), by planimetric measurement of total lung volume. FLV/FBW was also calculated. The presence of the pulmonary hypoplasia in neonates was identified based on clinical and anatomico‐pathological findings. Differences in LLSIR and FLV/FBW were analyzed for surviving and non‐surviving neonates. Results: Ten surviving neonates had a median LLSIR of 3.00, range: 1.60–4.40, while that in seven non‐surviving neonates was 2.21, range: 0.70–3.72; no significant difference was found between the groups. Surviving neonates had a median FLV/FBW of 11.4, range: 7.1–15.7, while that in non‐surviving neonates was 4.4, range: 3.1–5.7. FLV/FBW in non‐surviving neonates was significantly lower than that of the FLV/FBW for surviving fetuses ( P < 0.05). Conclusions: Low FLV/FBW may be useful in prenatally predicting mortality in fetuses with pulmonary hypoplasia.