Liu Danyi, Jiang Qiuxia, Xu Ziwei, Li Liya, Lyu Guorong
Department of Ultrasound, Second Affiliated Hospital of Fujian Medical University, Quanzhou, China.
Department of Ultrasound, Quanzhou Women's and Children's Hospital, Quanzhou, China.
Quant Imaging Med Surg. 2024 Aug 1;14(8):5373-5384. doi: 10.21037/qims-24-272. Epub 2024 Jul 30.
Noninvasive evaluation of fetal lung development is a critical area of study. Two-dimensional shear-wave elastography (2D-SWE) provides valuable insights into tissue stiffness, potentially correlating with different stages of lung development. This study aims to explore the potential of the 2D-SWE technique for assessing the maturity of fetal lung development.
This prospective cohort study included pregnant women undergoing routine antenatal ultrasound examinations at the Second Affiliated Hospital of Fujian Medical University and Quanzhou Women's and Children's Hospital from September 2022 to September 2023. The study consecutively recruited 300 pregnant women with normal pregnancies and 15 who opted for induced labor. Among those with normal pregnancies, the study assessed the differences in fetal pulmonary and hepatic elasticity measurements across different gestational weeks (GW) using one-way analysis of variance (ANOVA). Furthermore, regression analyses using linear, quadratic, and cubic equations were conducted to investigate the relationship between fetal parameters and GW. For those who opted for induced labor, elasticity measurements were taken before induction, and fetal lung tissue specimens were collected for post-induction observation.
Fetal lung and liver elasticity values, along with the lung-to-liver elasticity ratio (LLE ratio), showed significant variations across different GW (P<0.05). Specifically, fetal lung elasticity values initially increased and then decreased as GW advanced (R2=0.41). Liver elasticity values continuously increased throughout GW, though the rate of increase diminished during the prenatal period (R2=0.37). The LLE ratio values increased and then decreased over GW, fluctuating overall between 0.8 and 0.9 (R2=0.14). A 71.4% concordance was observed between the predicted stage of lung development, based on lung elasticity values, and the histological stage of lung development in the induced fetuses.
2D-SWE can depict the maturation of fetal lung development at various stages.
胎儿肺发育的无创评估是一个关键的研究领域。二维剪切波弹性成像（2D-SWE）能提供有关组织硬度的有价值信息，可能与肺发育的不同阶段相关。本研究旨在探索2D-SWE技术评估胎儿肺发育成熟度的潜力。
这项前瞻性队列研究纳入了2022年9月至2023年9月在福建医科大学附属第二医院和泉州市妇幼保健院接受常规产前超声检查的孕妇。该研究连续招募了300名正常妊娠的孕妇和15名选择引产的孕妇。在正常妊娠的孕妇中，该研究使用单因素方差分析（ANOVA）评估不同孕周（GW）胎儿肺和肝弹性测量值的差异。此外，进行了线性、二次和三次方程的回归分析，以研究胎儿参数与GW之间的关系。对于选择引产的孕妇，在引产前行弹性测量，并采集胎儿肺组织标本进行引产术后观察。
胎儿肺和肝弹性值以及肺与肝弹性比值（LLE比值）在不同GW间存在显著差异（P<0.05）。具体而言，胎儿肺弹性值最初随着GW增加而升高，随后下降（R2=0.41）。肝弹性值在整个GW期间持续升高，尽管在产前阶段升高速率有所下降（R2=0.37）。LLE比值在GW间先升高后下降，总体在0.8至0.9之间波动（R2=0.14）。基于肺弹性值预测的肺发育阶段与引产胎儿的肺发育组织学阶段之间观察到71.4%的一致性。
2D-SWE能够描绘胎儿肺发育各阶段的成熟情况。
