The use of Advanced MRI techniques to evaluate antenatal lung development.

肺发育不足(称为肺发育不良)是一种相对常见的事件，每1000例孕妇中就有1例发生。在这些婴儿中，有50%的肺太小，无法在出生后长期存活。危险因素包括24周前胎膜破裂、婴儿周围羊水丢失或婴儿存在先天性心脏或胸部异常目前，在临床实践中，可以使用超声波或基础磁共振成像(MRI)来评估怀孕期间婴儿肺的大小。后者是一种安全扫描，使用磁铁来创建婴儿的图像。估计的大小提供了一些关于婴儿出生后是否会存活的信息，但这两项评估都没有提供有关肺发育变化的详细信息，比如肺空间是如何形成的，也没有提供出生后肺功能的详细信息。先进的MRI技术可以提供关于正常和异常肺发育的更深入的信息。这项研究将使用这些先进的核磁共振技术来观察正常怀孕期间(100个怀孕)婴儿的肺在子宫中的发育情况。然后，我们将评估70例有肺发育不良高风险的孕妇，以评估在这种情况下发生的肺发育的特殊变化。所有女性都将在怀孕期间接受核磁共振扫描。对于无并发症妊娠的女性，这将在怀孕16至42周期间进行一次。对于有肺发育不良风险的怀孕妇女，我们将进行两次MRI扫描，一次是在我们确定她们为高风险时，另一次是在怀孕后期。我们将在婴儿出生后收集有关他们的信息，例如他们是否存活，是否需要氧气或其他治疗来帮助他们呼吸。出生后，我们还将使用一种名为氦稀释的技术来评估肺部的功能。在这个安全的测试中，婴儿呼吸的是氦(一种无害的气体)，这使我们能够计算出婴儿的肺的实际大小。在未来，这一新知识可能有助于对婴儿出生后肺部功能的个性化咨询。目前，怀孕早期失去婴儿周围积水或胸部或心脏有其他异常的妇女可以选择终止妊娠，因为肺发育不全的风险很高，但有些孩子活了下来，尽管生活质量各不相同。这些新的核磁共振扫描也可能有助于监测旨在改善肺部生长和发育的潜在治疗方法，如手术或子宫内给药。

Inadequate development of the lungs (known as pulmonary hypoplasia) is a relatively common event, occurring in 1 in 1000 pregnancies. In 50% of these babies the lungs are too small for long term survival after birth. Risk factors include rupture of the membranes before twenty-four weeks with loss of the amniotic fluid surrounding the baby or the presence of a congenital abnormality of the baby's heart or chest At present, in clinical practice, the size of the baby's lungs can be evaluated during the pregnancy using either ultrasound or basic magnetic resonance imaging (MRI). The latter are safe scans which use magnets to create images of the baby. Estimated size gives some information about whether a baby will survive after birth but neither of these assessments provide detailed information about alterations in lung development such as how the air spaces are forming or indicate how the lungs might function after birth. Advanced MRI techniques could provide more in depth information about both normal and abnormal lung development. This study will use these advanced MRI techniques to see how babies' lungs develop in the womb during normal pregnancies (100 pregnancies). We will then assess 70 pregnancies at high risk of pulmonary hypoplasia to assess the specific alterations in lung development that occur in this condition. All women will undergo an MRI scan during their pregnancy. In women with uncomplicated pregnancies this will be once during the pregnancy between 16 and 42 weeks. In women with pregnancies at risk of pulmonary hypoplasia we will perform two MRI scans, one when we identify them as high risk and another later in the pregnancy. We will collect information on the babies after birth such as if they survive, need oxygen or other treatments to help them breathe. After birth we will also assess how the lungs are functioning using a technique called helium dilution. During this safe test the baby breathes in helium (a non-harmful gas) which allows us to calculate the actual size of the babies' lungs. In the future this new knowledge may help individualize counselling as to how a baby's lungs are likely to function after birth. Currently women who lose the waters around the baby early in the pregnancy or have other abnormalities with the chest or heart are given the option of termination of pregnancy due to the high risk of pulmonary hypoplasia however some children do survive although with varying qualities of life. These new MRI scans may also help to monitor potential treatments aimed at improving lung growth and development such as surgery or medications administered in the womb.