A Novel Fetal Magnetic Resonance Imaging Lung Volume Nomogram Stratified by Estimated Fetal Weight.

IF 1.6 3区 医学 Q3 OBSTETRICS & GYNECOLOGY Fetal Diagnosis and Therapy Pub Date : 2024-01-01 Epub Date: 2024-06-06 DOI:10.1159/000539709
Sivan Farladansky-Gershnabel, Praveen Jayapal, Max Zalcman, Richard A Barth, Erika Rubesova, Susan R Hintz, Jiaqi Zhang, Stephanie A Leonard, Yasser Y El-Sayed, Yair J Blumenfeld
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引用次数: 0

Abstract

Introduction: Fetal magnetic resonance imaging (MRI) lung volume nomograms are increasingly used to prognosticate neonatal outcomes in fetuses with suspected pulmonary hypoplasia. However, pregnancies complicated by fetal anomalies associated with pulmonary hypoplasia may also be complicated by fetal growth restriction (FGR). If a small lung volume is suspected in such cases, it is often unclear whether the lungs are "small" because of underlying lung pathology, or small fetal size. Existing MRI lung volume nomograms have mostly been stratified by gestational age (GA), rather than estimated fetal weight (EFW). Therefore, we aimed to develop a novel fetal lung volume nomogram stratified by EFW.

Methods: Consecutive fetal MRIs performed at a quaternary medical center from 2019 to 2021 were analyzed. MRIs performed due to fetal lung anomalies and cases with FGR were excluded. All MRIs were performed without IV contrast on GE 3 or 1.5 Tesla scanners (GE Healthcare). Images were reviewed by three experienced fetal radiologists. Freehand ROI in square centimeter was drawn around the contours of the lungs on consecutive slices from the apex to the base. The volume of the right, left and total lungs were calculated in mL. Lung volumes were plotted by both EFW and GA.

Results: Among 301 MRI studies performed during the study period, 170 cases met inclusion criteria and were analyzed. MRIs were performed between 19- and 38-week gestation, and a sonographic EFW was obtained within a mean of 2.9 days (SD ± 5.5 days, range 0-14 days) of each MRI. Nomograms stratified by both EFW and GA were created using 200 g. and weekly intervals respectively. A formula using EFW to predict total lung volume was calculated: LV = 0.07497804 EFW0.88276 (R2 = 0.87).

Conclusions: We developed a novel fetal lung volume nomogram stratified by EFW. If validated, this nomogram may assist clinicians predict outcomes in cases of fetal pulmonary hypoplasia with concomitant FGR.

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按估计胎儿体重分层的新型胎儿核磁共振肺容积提名图。
导言:胎儿磁共振成像肺容积提名图越来越多地被用于预测疑似肺发育不全胎儿的新生儿预后。然而,与肺发育不全相关的胎儿畸形也可能并发胎儿生长受限。在这种情况下,如果怀疑胎儿肺容积过小,往往不清楚肺容积 "过小 "是由于潜在的肺部病变,还是由于胎儿过小。现有的核磁共振肺容积提名图大多是根据胎龄(GA)而非估计胎儿体重(EFW)分层的。因此,我们旨在开发一种新型的以 EFW 为分层的胎儿肺容积提名图:方法:对一家四级医疗中心从 2019 年至 2021 年连续进行的胎儿 MRI 进行了分析。排除了因胎儿肺部异常而进行的磁共振成像以及FGR病例。所有核磁共振成像均在通用电气 3 或 1.5 特斯拉扫描仪(通用电气医疗保健公司)上进行,无静脉注射造影剂。图像由三位经验丰富的胎儿放射科医生审阅。以平方厘米为单位,在肺部轮廓周围绘制从顶部到底部的连续切片的自由ROI。以毫升为单位计算右肺、左肺和总肺的体积。肺容积由 EFW 和 GA 两种方法绘制:在研究期间进行的 301 次核磁共振成像检查中,有 170 例符合纳入标准并进行了分析。核磁共振成像在妊娠19周至38周之间进行,每次核磁共振成像后平均2.9天(SD±5.5天,范围0-14天)内获得超声EFW。分别以 200 克和每周为间隔,绘制了按 EFW 和 GA 分层的提名图。利用 EFW 计算出预测肺总量的公式:LV=0.07497804 EFW0.88276 (R2=0.87):结论:我们开发了一种新的胎儿肺容积提名图,以 EFW 为分层。结论:我们开发了新的以 EFW 为分层的胎儿肺容积提名图,如果得到验证,该提名图可帮助临床医生预测胎儿肺发育不全合并 FGR 病例的预后。
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来源期刊
Fetal Diagnosis and Therapy
Fetal Diagnosis and Therapy 医学-妇产科学
CiteScore
4.70
自引率
9.10%
发文量
48
审稿时长
6-12 weeks
期刊介绍: The first journal to focus on the fetus as a patient, ''Fetal Diagnosis and Therapy'' provides a wide range of biomedical specialists with a single source of reports encompassing the common discipline of fetal medicine.
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