Diffusion‐weighted MRI in lungs of normal fetuses and those with congenital diaphragmatic hernia
Open Access
- 28 October 2009
- journal article
- research article
- Published by Wiley in Ultrasound in Obstetrics & Gynecology
- Vol. 34 (6) , 678-686
Abstract
Objective: To prospectively determine apparent diffusion coefficient (ADC) values of normally developing fetal lungs over gestation, as obtained by diffusion‐weighted (DW) magnetic resonance imaging (MRI) and to investigate its potential application in fetuses with congenital diaphragmatic hernia (CDH).Methods: Informed consent was obtained for this cross‐sectional study of 93 fetuses with normal lungs and 14 with isolated left‐sided CDH, assessed between 18 and 40 weeks of gestation. MRI delineation of left and right lungs was performed on the native DW image, b0, and three values of ADC, corresponding to the overall value (ADCavg), and values for low and high values of b (ADClow and ADChigh, respectively) were calculated. Regression analysis was used to assess the relationship between gestational age and b0‐values as well as calculated ADC values. The b0 and ADC values of normal and CDH fetuses were compared with normal ranges using the Mann–Whitney U‐test.Results: In fetuses with normal lungs, there was a negative correlation between gestational age and b0 values as well as with ADChigh, a positive correlation with ADClow but no correlation with ADCavg. When measurable, ADChigh values were lower in CDH as compared to fetuses with normal lungs and ADClow values were higher. ADClow was unrelated to lung volume.Conclusions: There is a significant relationship between ADClow and ADChigh values and gestational age in normal fetal lungs. This relationship is most probably explained by developmental changes during the last three stages of lung development, which involve intense peripheral growth of airways and vessels as well as maturation. In CDH, measurement of ADClow might be useful as a predictor of postnatal outcome that is independent of lung volume. Copyright © 2009 ISUOG. Published by John Wiley & Sons, Ltd.Keywords
This publication has 21 references indexed in Scilit:
- Fetal Body Volume: Use at MR Imaging to Quantify Relative Lung Volume in Fetuses Suspected of Having Pulmonary HypoplasiaRadiology, 2006
- Quantitative analysis of fetal pulmonary vasculature by 3-dimensional power Doppler ultrasonography in isolated congenital diaphragmatic herniaAmerican Journal of Obstetrics and Gynecology, 2006
- Fetal pulmonary artery diameter measurements as a predictor of morbidity in antenatally diagnosed congenital diaphragmatic hernia: A prospective studyAmerican Journal of Obstetrics and Gynecology, 2006
- Lung and heart volumes by three-dimensional ultrasound in normal fetuses at 12–32 weeks' gestationUltrasound in Obstetrics & Gynecology, 2005
- Prenatal prediction of survival in isolated left‐sided diaphragmatic herniaUltrasound in Obstetrics & Gynecology, 2005
- Assessment of lung area in normal fetuses at 12–32 weeksUltrasound in Obstetrics & Gynecology, 2005
- Diffusion-weighted MR Imaging of Kidneys in Healthy Volunteers and Patients with Parenchymal Diseases: Initial ExperienceRadiology, 2005
- Fetal Lung Volume: Estimation at MR Imaging—Initial ResultsRadiology, 2001
- In vivo diffusion measurements as an indication of fetal lung maturation using echo planar imaging at 0.5TMagnetic Resonance in Medicine, 2001
- Separation of diffusion and perfusion in intravoxel incoherent motion MR imaging.Radiology, 1988