Pulmonary hypoplasia: Prediction with use of ratio of MR imaging-measured fetal lung volume to US-estimated fetal body weight
Pulmonary hypoplasia: Prediction with use of ratio of MR imaging-measured fetal lung volume to US-estimated fetal body weight
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DOI：
10.1148/radiol.2323030359
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发表时间：
2004-09-01
期刊：
影响因子：
19.7
通讯作者：
Yoshimura, Y
中科院分区：
文献类型：
--
作者：
Tanigaki, S;Miyakoshi, K;Yoshimura, Y
目的：通过超声（US）和磁共振（MR）成像测定胎儿肺体积（FLV）与胎儿体重（FBW）的比值，并评价该比值在预测高危胎儿肺发育不全（PH）中的应用价值。材料与方法：对90例妊娠25-39周的胎儿进行MR成像肺容量测定和US生物测定。在对照组73例胎儿中，在新生儿随访中确认肺发育正常，并确定MR成像测量的FLV与us估计的FBW （FLV/FBW）的规范比率。高危组包括17例有PH风险的胎儿。比较对照组和高危组之间的FLV/FBW，并与预测高危组PH发展的US参数进行比较。测量值低于对照组平均测量值2个或更多标准差被认为是异常。各组间FLV/FBW比较采用Student t检验。利用Fisher精确概率检验分析了PH的发展与各参数测量之间的关系。结果：对照组妊娠晚期FLV/FBW随胎龄下降，呈正态分布（比值平均值0.028 mL/g，范围0.015 ~ 0.444 mL/g）。PH值为0.012 mL/g +/- 0.008的9例胎儿FLV/FBW的平均值显著低于对照组（0.028 mL/g +/- 0.007） （P < 0.001）。FLV/FBW值异常的胎儿PH发育风险显著增加（P < 0.05）。异常FLV/FBW值诊断准确率高于异常US参数。FLV/FBW的敏感性为89%（9个胎儿中有8个）；特异性，88%（8个胎儿中有7个）；阳性预测值89%（9个胎儿中有8个）；阴性预测值88%（8个胎儿中有7个）；准确率为88%（17个胎儿中有15个）。结论：FLV/FBW反映了宫内肺生长的充分性，可以帮助预测PH. (C) RSNA, 2004。
PURPOSE: To determine the ratio of fetal lung volume (FLV) to fetal body weight (FBW) by using ultrasonography (US) and magnetic resonance (MR) imaging and to evaluate the usefulness of this ratio in predicting pulmonary hypoplasia (PH) in fetuses at high risk.MATERIALS AND METHODS: MR imaging lung volumetry and US biometry were performed in 90 fetuses at 25-39 weeks gestation. In the control group of 73 fetuses, normal lung development was confirmed at neonatal follow-up and the normative ratio of MR imaging-measured FLV to US-estimated FBW (FLV/FBW) was determined. The high-risk group included 17 fetuses at risk for PH. The FLV/FBW was compared between the control and high-risk groups and with US parameters for predicting the development of PH in the high-risk group. Measurements 2 or more standard deviations below the mean control group measurement were considered abnormal. Comparisons of the FLV/FBW between groups were made by using the Student t test. The association between development of PH and measurement of each parameter was analyzed by using the Fisher exact probability test.RESULTS: In the control group, the FLV/FBW decreased with gestational age during the third trimester and had a normal distribution (mean ratio, 0.028 mL/g; range, 0.015-0.444 mL/g). The mean FLV/FBW for the nine fetuses with PH (0.012 mL/g +/- 0.008) was significantly lower (P < .001) than that for the control group (0.028 mL/g +/- 0.007). Fetuses with abnormal FLV/FBW values were at significantly greater risk (P < .05) for PH development. Abnormal FLV/FBW values had higher diagnostic accuracy than abnormal US parameters. Sensitivity of the FLV/FBW was 89% (eight of nine fetuses); specificity, 88% (seven of eight fetuses); positive predictive value, 89% (eight of nine fetuses); negative predictive value, 88% (seven of eight fetuses); and accuracy, 88% (15 of 17 fetuses).CONCLUSION: The FLV/FBW reflects the adequacy of intrauterine lung growth and can help predict PH. (C) RSNA, 2004.