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

肺发育不全（称为肺发育不全）是一种相对常见的现象，每1000个怀孕中就有1个发生。在这些婴儿中，有50%的婴儿出生后肺部太小，无法长期存活。危险因素包括24周前胎膜破裂，伴有胎儿周围羊水的丢失，或胎儿心脏或胸部存在先天性异常。目前，在临床实践中，可以在怀孕期间使用超声或基本磁共振成像（MRI）来评估婴儿肺部的大小。后者是安全的扫描，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能存活的信息，但这些评估都不能提供关于肺发育变化的详细信息，比如空气空间是如何形成的，也不能表明出生后肺的功能如何。先进的MRI技术可以提供更多关于正常和异常肺发育的深入信息。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（100次怀孕）期间婴儿肺部在子宫内的发育情况。然后，我们将评估70例肺发育不全高危妊娠，以评估在这种情况下肺部发育的具体改变。所有女性在怀孕期间都会接受核磁共振扫描。对于妊娠无并发症的妇女，在妊娠16至42周期间进行一次。对于有肺发育不全风险的孕妇，我们将进行两次核磁共振扫描，一次是在我们确定为高风险时，另一次是在怀孕后期。我们将收集婴儿出生后的信息，比如他们是否存活，是否需要氧气或其他治疗来帮助他们呼吸。出生后，我们还将使用一种叫做氦稀释的技术来评估肺部的功能。在这个安全测试中，婴儿吸入氦气（一种无害的气体），这样我们就可以计算出婴儿肺的实际大小。在未来，这一新发现可能有助于对婴儿出生后肺部功能的个性化咨询。目前，在怀孕早期失去婴儿周围水分或胸部或心脏有其他异常的妇女可以选择终止妊娠，因为肺部发育不全的风险很高，但有些孩子确实存活了下来，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，如手术或在子宫内进行药物治疗。

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.