Two- or three-dimensional ultrasonography: which is the best predictor of pulmonary hypoplasia?
OBJECTIVE
The aim of our study is to compare the three-dimensional (3D) ultrasound fetal lung volume measurements with two-dimensional (2D) ultrasound biometric parameters in predicting pulmonary hypoplasia (PH).


METHODS
From June 2006 to November 2008, we identified 35 fetuses at high risk for developing PH, including premature preterm rupture of membranes (17), fetal skeletal malformations (7), hydrothorax (7), and bilateral renal dysplasia (4). 3D lung volumes adjusted for gestational age (GA) or estimated fetal weight (EFW), thoracic circumference adjusted for GA or femur length, thoracic/abdominal circumference ratio, and thoracic/heart area ratio were measured.


RESULTS
Three infants were excluded because no clinical or histological information regarding lung hypoplasia was available. Of the 32 remaining infants, 13 (41%) were diagnosed with PH at postmortem examination or by clinical and radiological examination. 3D lung volume measurements had a better diagnostic accuracy for predicting PH either when adjusted for GA [sensitivity, 12/13 (92%); specificity, 16/19 (84%); positive predictive value 12/15 (80%); negative predictive value, 16/17(94%)] or EFW [sensitivity, 11/13 (85%); specificity, 18/19 (94%); positive predictive value 11/12(92%); negative predictive value, 18/20(90%)] compared to the 2D biometric measurement.


CONCLUSIONS
3D lung volume measurements seem to be useful in the prenatal prediction of PH.
Vergani
Patrizia
P
Department of Obstetrics and Gynecology, University of Milano-Bicocca, Monza, Italy. pvergani@yahoo.it
Andreani
Marianna
M
Greco
Massimiliano
M
Farina
Giuliano
G
Fedeli
Tiziana
T
Cuttin
Serena
S
D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging*; D005325:Fetal Organ Maturity; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional; D007231:Infant, Newborn; D008168:Lung / Q000002:abnormalities / Q000000981:diagnostic imaging*; D008176:Lung Volume Measurements / Q000379:methods; D008297:Male; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011247:Pregnancy; D016216:Ultrasonography, Prenatal / Q000379:methods*