title: 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.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan. bachi1970@sis.seirei.or.jp
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Matsushita
authors.forename: Keisuke
authors.initials: K
authors.lastname: Ishii
authors.forename: Masaki
authors.initials: M
authors.lastname: Tamura
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Takahashi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kamura
authors.forename: Koichi
authors.initials: K
authors.lastname: Takakuwa
authors.forename: Kenichi
authors.initials: K
authors.lastname: Tanaka
mesh_terms: 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