title: Clinical significance of the lung/thorax transverse-area ratio in fetuses with cystic lung disease.
abstract: We examined the clinical significance of the lung-thorax transverse-area ratio (L/T) in fetuses with cystic lung disease (CLD). The transverse section of the thorax was analyzed at the level of the 4-chamber view of the heart. L/T was calculated as the bilateral normal lung area divided by the thoracic area. Within a 9-year period, ultrasonography was performed in 15 fetuses with CLD, 13 of which were histologically diagnosed: congenital cystic adenomatoid malformation of the lung (CAM; n = 8), pulmonary sequestration (n = 4), and bronchial atresia (n = 1). Although the initial L/T measurement (29.6 +/- 4.2 weeks) showed significantly lower values than in the controls, the final measurement (36.4 +/- 1. 6 weeks) indicated that the L/T in CLD excluding CAM was significantly higher than that in CAM. Six patients with a final L/T of less than 0.21 required mechanical ventilation immediately after birth. Two of these patients died, and the autopsy findings indicated pulmonary hypoplasia. In these cases, a significant correlation was observed between the maximal value of L/T and preductal alveolar-arterial oxygen difference (A-aDO(2)), although the final L/T was not correlated to A-aDO(2). These results indicate that serial measurements of L/T may be useful in the diagnosis of CLD and may help to predict postnatal respiratory conditions.
authors.affiliation: Department of Pediatric Surgery, Osaka University Medical School and Medical Center for Maternal and Child Health, Osaka, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Kamata
authors.forename: S
authors.initials: S
authors.lastname: Ishikawa
authors.forename: N
authors.initials: N
authors.lastname: Usui
authors.forename: T
authors.initials: T
authors.lastname: Sawai
authors.forename: Y
authors.initials: Y
authors.lastname: Kitayama
authors.forename: K
authors.initials: K
authors.lastname: Nose
authors.forename: H
authors.initials: H
authors.lastname: Okuyama
authors.forename: K
authors.initials: K
authors.lastname: Imura
authors.forename: A
authors.initials: A
authors.lastname: Okada
mesh_terms: D001998:Bronchopulmonary Sequestration / Q000000981:diagnostic imaging*; D015615:Cystic Adenomatoid Malformation of Lung, Congenital / Q000000981:diagnostic imaging*; D005315:Fetal Diseases / Q000000981:diagnostic imaging*; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D013909:Thorax / Q000000981:diagnostic imaging*; D016216:Ultrasonography, Prenatal