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.
OBJECTIVE
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.
Matsushita
Mitsuru
M
Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan. bachi1970@sis.seirei.or.jp
Ishii
Keisuke
K
Tamura
Masaki
M
Takahashi
Yasuhiro
Y
Kamura
Takeshi
T
Takakuwa
Koichi
K
Tanaka
Kenichi
K
D015615:Cystic Adenomatoid Malformation of Lung, Congenital / Q000175:diagnosis*; D005260:Female; D005333:Fetus; D006548:Hernia, Diaphragmatic / Q000175:diagnosis*; D065630:Hernias, Diaphragmatic, Congenital; D006801:Humans; D007231:Infant, Newborn; D008176:Lung Volume Measurements / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D018743:Perinatal Care / Q000379:methods; D011247:Pregnancy; D012189:Retrospective Studies