Low-intensity fetal lungs on MRI may suggest the diagnosis of pulmonary hypoplasia

Kuwashima, Shigeko; Nishimura, Gen; Iimura, Fumitoshi; Kohno, Tatsuo; Watanabe, Hiroshi; Kohno, Atsushi; Fujioka, Masashi

doi:10.1007/s002470100512

Cited by 87 publications

(63 citation statements)

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“…5 Right pulmonary hypoplasia shows asymmetrically decreased right lung volume with abnormally low signal intensity. 6 In this case, diagnosis was made postnatally. We should have researched other importantˆndings after recognizing the right-sided heart.…”

Section: Discussionmentioning

confidence: 90%

Fetal MR Imaging Diagnosis of Pulmonary Agenesis

Kuwashima

Kaji

2010

magn reson med sci

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Fig. 1. T 2 -weighted coronal image shows displacement of the heart to the right with small right hemithorax and overdistension of the left lung. Note complete absence of the right main bronchus and normal left main bronchus (arrow). 149Magn Reson Med Sci, Vol. 9, No. 3, pp. 149-152, 2010 CASE REPORT Fetal MR Imaging Diagnosis of Pulmonary AgenesisShigeko KUWASHIMA* and Yasushi KAJI Department of Radiology, Dokkyo Medical University 880 Kitakobayashi, Mibu-machi, Shimotsuka-gu, Tochigi 321-0293, Japan (Received January 14, 2010; Accepted March 24, 2010)A woman was referred to our institution with an ultrasound (US) suggestive of right-sided heart in fetus at 34 weeks' gestation. Magnetic resonance (MR) imaging revealed rightsided heart, small right hemithorax, and completely absent right main bronchus and right pulmonary artery. From our experience with this case, we point out 5 important MR imagingˆndings needed for prenatal diagnosis of pulmonary agenesis. Fetal MR imaging also provided information about anomalies of other organs.

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Section: Discussionmentioning

confidence: 90%

Fetal MR Imaging Diagnosis of Pulmonary Agenesis

Kuwashima

Kaji

2010

magn reson med sci

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“…The pathological findings of both lungs, ipsi-and contralateral to the herniated side, are the same in the rat model of CDH (23). In addition, Kuwashima et al have suggested that the high SI of HASTE represents a substantial amount of fetal lung fluid in the voluminous small airways and alveoli that are formed as the lung grows and comes to maturity (22). According to these previous reports, we considered it reasonable to note the SI of the contralateral lung.…”

Section: Discussionmentioning

confidence: 56%

“…Lung hypoplasia is histologically defined as a decrease in the number of airway generations and the number of alveoli (22). The pathological findings of both lungs, ipsi-and contralateral to the herniated side, are the same in the rat model of CDH (23).…”

Section: Discussionmentioning

confidence: 99%

“…Although fetal biometry may be a better predictor of expected fetal lung volume (28,29), we used GA because it was associated with the LLSIR, which was the main target to be evaluated in our study. And finally, the production of fetal lung fluid, which reflects high signal intensity on HASTE, starts in the second trimester and the interstitium of the lung becomes gradually thinner (22). Therefore, Brewerton et al (16) suggested that a clear distinction between hypoplastic and normal lungs is obtained at 25 weeks of gestation or more.…”

Section: Discussionmentioning

confidence: 99%

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MR prediction of postnatal outcomes in left‐sided congenital diaphragmatic hernia using right lung signal intensity: Comparison with that using right lung volume

Nishie

Tajima

Asayama

et al. 2009

Magnetic Resonance Imaging

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Purpose: 1 To investigate the validity of the fetal right lungto-liver signal intensity ratio (LLSIR) for prediction of postnatal outcomes in left-sided congenital diaphragmatic hernia (CDH). Materials and Methods:The study included 14 pregnant women who underwent MR exams for evaluation of fetal left-sided CDH. The fetuses were divided into two groups: Group A (n ϭ 9), alive, and Group B (n ϭ 5), dead. On the basis of the half-Fourier acquisition single-shot turbo spinecho sequence, LLSIR and the right fetal lung volume (FLV) was calculated. In the control group, a regression analysis was performed to associate LLSIR and right FLV with gestational age. The relative LLSIR and right FLV (the observed/expected LLSIR and right FLV) were compared between Groups A and B. Results:The mean relative LLSIR, as well as the mean relative right FLV, of Group A was significantly higher than that of Group B (p ϭ 0.035). Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for the relative LLSIR and the relative right FLV, when the cutoff point was defined as 0.646 and 0.420, were the same and were 88.9%, 80.0%, 88.9%, 80.0%, and 85.7%, respectively. Conclusion:The postnatal outcomes in left-sided CDH may be predicted using the LLSIR.

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“…Low MRI intensity in T2-weighted image is thought to be a sign of pulmonary hypoplasia clinically, 17,18 and animal study also showed it. 19 However, the meaning of MRI signal intensity of the CDH lung remains controversial.…”

Section: Discussionmentioning

confidence: 95%

Prediction of postnatal outcomes in congenital diaphragmatic hernia using MRI signal intensity of the fetal lung

et al. 2010

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Objective: Prognostic prediction in prenatally diagnosed congenital diaphragmatic hernia (CDH) is needed. The aim of the study was to evaluate magnetic resonance imaging (MRI) signal intensity of the fetal lung as a predictor of prognosis in CDH.Study Design: The subjects consisted of 12 fetuses with prenatally diagnosed CDH, who were treated soon after the birth in our institution. They all underwent MRI at 29 to 37 weeks of gestation. The ratio of the lung signal intensity to the spinal fluid signal intensity (L/SF) was calculated using region-of-interest analysis of T2-weighted images. The relationship between L/SF and clinical data was then examined.Result: L/SF were significantly larger in survivors compared with deaths (0.815 vs 0.614, P<0.05). In survivors, L/SF significantly correlated with duration of tracheal intubation (rs ¼ À0.938, P<0.01).Conclusion: L/SF is a unique factor to predict the survival prognosis and likely to quantify the degree of pulmonary hypoplasia in CDH.

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Low-intensity fetal lungs on MRI may suggest the diagnosis of pulmonary hypoplasia

Abstract: Low-intensity fetal lung on MRI imaging indicates pulmonary hypoplasia after 26 weeks' gestation.

Cited by 87 publications

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Fetal MR Imaging Diagnosis of Pulmonary Agenesis

Fetal MR Imaging Diagnosis of Pulmonary Agenesis

MR prediction of postnatal outcomes in left‐sided congenital diaphragmatic hernia using right lung signal intensity: Comparison with that using right lung volume

Prediction of postnatal outcomes in congenital diaphragmatic hernia using MRI signal intensity of the fetal lung

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