Gerards Franca A, Twisk Jos W R, Fetter Willem P F, Wijnaendts Liliane C D, van Vugt John M G
Department of Obstetrics and Gynecology, VU University Medical Center, Amsterdam, The Netherlands.
Am J Obstet Gynecol. 2008 Jan;198(1):140.e1-6. doi: 10.1016/j.ajog.2007.06.005.
The aim of this study was to compare 3-dimensional (3D) lung volume measurements with 2-dimensional (2D) biometric parameters in predicting pulmonary hypoplasia in complicated pregnancies.
In this prospective study, 1-4 scans of the fetal lungs were obtained in 33 pregnancies complicated by various disorders or complications with regard to pulmonary hypoplasia. The 3D lung volumes vs gestational age or estimated fetal weight, the thoracic circumference vs gestational age or femur length, the thoracic/abdominal circumference ratio, and the thoracic/heart area ratio were measured.
Of the 33 infants, 16 (48.5%) were diagnosed with pulmonary hypoplasia on postmortem examination or the clinical and radiological presentation. Three dimensional lung volume measurements had a better diagnostic accuracy for predicting pulmonary hypoplasia (sensitivity, 94%; specificity, 82%; positive predictive value [PPV], 83%; negative predictive value [NPV], 93%), compared with the best 2D biometric measurement thoracic/heart area ratio (sensitivity, 94%; specificity, 47%; PPV, 63%; NPV, 89%).
3D lung volume measurements seem to be useful in predicting pulmonary hypoplasia prenatally.
本研究旨在比较三维（3D）肺容积测量与二维（2D）生物测量参数在预测复杂妊娠中肺发育不全方面的作用。
在这项前瞻性研究中，对33例因各种与肺发育不全相关的疾病或并发症而复杂化的妊娠进行了1 - 4次胎儿肺部扫描。测量了三维肺容积与胎龄或估计胎儿体重、胸围与胎龄或股骨长度、胸/腹围比以及胸/心面积比。
在这33例婴儿中，16例（48.5%）在尸检或临床及影像学表现上被诊断为肺发育不全。与最佳的二维生物测量指标胸/心面积比相比，三维肺容积测量在预测肺发育不全方面具有更好的诊断准确性（敏感性94%；特异性82%；阳性预测值[PPV]83%；阴性预测值[NPV]93%），胸/心面积比的诊断准确性为（敏感性94%；特异性47%；PPV 63%；NPV 89%）。
三维肺容积测量似乎有助于产前预测肺发育不全。
