In fetuses with normal lungs, FLV distribution against gestational age is easily assessed in utero with fast spin-echo T2-weighted MR imaging. These preliminary findings illustrate the potential for comparing FLV measurements in fetuses at risk of lung hypoplasia with normative values.

MRI is a valuable complementary tool when prenatal US is incomplete, doubtful or limited. Prenatal MRI is particularly useful for the detection of ischaemic and haemorrhagic lesions, neuronal migration disorders and tuberous sclerosis lesions. Detection of these associated anomalies worsens the fetal prognosis, has medico-legal implications and modifies obstetric management. Normal prenatal MRI does not exclude an anomaly.

To assess the pattern of abdominal muscle contraction in stable patients with chronic obstructive pulmonary disease (COPD), we studied electromyograms of the rectus abdominis, external oblique, and transversus abdominis muscles in 40 patients with variable degrees of chronic airflow obstruction (FEV1 between 17 and 82% of predicted); 12 control subjects with normal pulmonary function tests were studied for comparison. The subjects were studied during resting breathing in the supine posture, and the electromyograms were recorded with concentric needle electrodes implanted with the aid of a high-resolution ultrasound. The rectus abdominis and external oblique were silent in virtually all patients. In contrast, 17 patients had invariable phasic expiratory activity in the transversus abdominis, and 11 additional patients had intermittent transversus expiratory activity. Expiratory contraction of the transversus was related to the degree of airflow obstruction (p less than 0.005), and when present, it persisted in the seated posture. We conclude that (1) when breathing at rest, many stable patients with severe chronic airflow obstruction contract the abdominal muscles during expiration, and (2) this expiratory contraction is usually confined to the transversus muscle. These observations also indicate that the physiology of dynamic hyperinflation and intrinsic positive end-expiratory pressure (PEEP) in such patients should be reevaluated.

Distinctive imaging characteristics are observed in cases of CH with US findings of visible vessels and calcifications statistically significant.

Our study opens a window on the distinctive genetic landscape associated with fetal anomalies and highlights the power-but also the challenges-of WES in prenatal diagnosis.