Jani J, Cannie M, Done E, Van Mieghem T, Van Schoubroeck D, Gucciardo L, Dymarkowski S, Deprest J A
Unit of Prenatal and Gynecological Ultrasound and Fetal Therapy, Department of Obstetrics and Gynecology, University Hospital Gasthuisberg, Leuven, Belgium.
Ultrasound Obstet Gynecol. 2007 Nov;30(6):855-60. doi: 10.1002/uog.5168.
To prospectively examine the relationship between contralateral lung area measured by two-dimensional (2D) ultrasound examination and contralateral and total fetal lung volume (FLV) estimated by magnetic resonance imaging (MRI) in the assessment of fetuses with congenital diaphragmatic hernia (CDH).
Sixty-six fetuses with isolated CDH were entered in this prospective study. Contralateral fetal lung area was measured by 2D ultrasonography using the longest axis method. Ipsilateral, contralateral and total FLV were measured using multiplanar axial T2-weighted MRI. Regression analysis was used to determine the significance of associations between contralateral lung area and contralateral and total FLV, and the predicted total FLV was subsequently calculated using the regression equation. Univariate regression analysis was used to investigate the effect on the proportionate difference between the predicted and the observed total FLV of gestational age, proportionate volume of ipsilateral vs. total FLV, side of CDH, intrathoracic herniation of the liver and intratracheal presence of a balloon.
The 66 fetuses underwent a total of 191 paired 2D ultrasound and MRI examinations at a median gestational age of 30 (range, 18-38) weeks. It was possible to visualize and measure the contralateral lung area by 2D ultrasound, as well as both the ipsilateral and contralateral lung volumes by MRI, in all instances. There was a significant association between contralateral lung area and contralateral lung volume (r = 0.86; P < 0.001) and with total FLV (r = 0.84; P < 0.001). Univariate regression analysis showed that the proportionate difference between the predicted and the observed total FLV was significantly associated with the proportionate volume of ipsilateral vs. total FLV but not with gestational age, side of CDH, intrathoracic herniation of the liver or intratracheal presence of the balloon.
In CDH, contralateral lung area measurement by 2D ultrasound correlates well with the total FLV estimated by MRI, irrespective of gestational age, liver herniation or side of herniation. Inconsistencies between the two measurements are attributable to the contribution of the ipsilateral lung to the total lung volume.
前瞻性研究二维（2D）超声检查测量的对侧肺面积与磁共振成像（MRI）估计的对侧及胎儿总肺体积（FLV）之间的关系，以评估先天性膈疝（CDH）胎儿。
66例孤立性CDH胎儿纳入本前瞻性研究。采用最长轴法通过2D超声测量对侧胎儿肺面积。使用多平面轴向T2加权MRI测量同侧、对侧及总FLV。采用回归分析确定对侧肺面积与对侧及总FLV之间关联的显著性，随后使用回归方程计算预测的总FLV。采用单变量回归分析研究胎龄、同侧与总FLV的比例体积、CDH的侧别、肝脏胸腔内疝入及气管内球囊的存在对预测与观察到的总FLV比例差异的影响。
66例胎儿在孕龄中位数为30（范围18 - 38）周时共接受了191次2D超声和MRI配对检查。在所有情况下，均可通过2D超声可视化并测量对侧肺面积，以及通过MRI测量同侧和对侧肺体积。对侧肺面积与对侧肺体积（r = ０.86；P < 0.001）及总FLV（r = 0.84；P < 0.001）之间存在显著关联。单变量回归分析显示，预测与观察到的总FLV比例差异与同侧与总FLV的比例体积显著相关，而与胎龄、CDH的侧别、肝脏胸腔内疝入或气管内球囊的存在无关。
在CDH中，无论胎龄、肝脏疝入或疝入侧别如何，通过2D超声测量的对侧肺面积与MRI估计的总FLV具有良好的相关性。两种测量方法之间的不一致归因于同侧肺对总肺体积的贡献。
