Abstract
Background
Pulmonary hypoplasia is a common cause of neonatal death.
Objective
To describe the correlation between relative fetal lung volume (RFLV) and lung-to-head ratio (LHR) in fetuses with unilateral diaphragmatic hernia. Additionally, to describe identification of the ipsilateral lung cap by power Doppler.
Materials and methods
Single-institution study of consecutive fetuses with diaphragmatic hernia. LHR (by US) and RFLV (by MRI) were correlated in fetuses with and without an ipsilateral lung cap seen at MRI. In four, color/power Doppler was used to follow the pulmonary artery of the ipsilateral lung to identify the compressed cap.
Results
The study included 48 fetuses of 20-38 weeks’ gestational age (mean, 26 weeks). Mean LHR was 1.52 (range, 0.6-3) in fetuses with a lung cap and 1.15 (range, 0.6-2.58) in fetuses without (P = 0.043). Mean RFLV was 47.4% (range, 18-80%) in fetuses with and 32.9% (range, 14-57%) in fetuses without a lung cap (P = 0.005). RFLV and LHR correlated (r = 0.41, P = 0.01 in those with a cap; r = 0.50, P = 0.05 in those without). Power Doppler identified the ipsilateral lung cap and pulsed Doppler confirmed pulmonary vascularization in four of four fetuses.
Conclusion
LHR underestimates lung volume in fetuses with an ipsilateral lung cap. Power Doppler may be useful for identifying the cap.
Similar content being viewed by others
References
Tanigaki S, Miyakoshi K, Tanaka M et al (2004) Pulmonary hypoplasia: prediction with use of ratio of MR imaging-measured fetal lung volume to US-estimated fetal body weight. Radiology 232:767–772
Rypens F, Metens T, Rocourt N et al (2001) Fetal lung volume: estimation at MR imaging-initial results. Radiology 219:236–241
Leung J, Coakley F, Hricak H et al (2000) Prenatal MR imaging of congenital diaphragmatic hernia. AJR 174:1607–1612
Coakley F, Lopoo J, Lu Y et al (2000) Normal and hypoplastic fetal lungs: volumetric assessment with prenatal single-shot rapid acquisition with relaxation enhancement MR imaging. Radiology 216:107–111
Paek B, Coakley F, Lu Y et al (2001) Congenital diaphragmatic hernia: prenatal evaluation with MR lung volumetry-preliminary experience. Radiology 220:63–67
Ruano R, Aubry M, Dumez Y et al (2008) Predicting neonatal deaths and pulmonary hypoplasia in isolated congenital diaphragmatic hernia using the sonographic fetal lung volume-body weight ratio. AJR 190:1216–1219
Wedegaertner U, Tchirikov M, Habermann Ch et al (2004) Fetal sheep with tracheal occlusion: monitoring lung development with MR imaging and B-mode US. Radiology 230:353–358
Ruano R, Joubin L, Sonigo P et al (2004) Fetal lung volume estimated by 3-dimensional ultrasonography and magnetic resonance imaging in cases with isolated congenital diaphragmatic hernia. J Ultrasound Med 23:353–358
Büsing K, Kilian AK, Schaible T et al (2008) MR relative fetal lung volume in congenital diaphragmatic hernia: survival and need for extracorporeal membrane oxygenation. Radiology 248:240–246
Büsing KA, Kilian AK, Schaible T et al (2008) MR lung volume in fetal congenital diaphragmatic hernia: logistic regression analysis-mortality and extracorporeal membrane oxygenation. Radiology 248:233–239
Cannie M, Jani J, Meercchaert J et al (2008) Prenatal prediction of survival in isolated diaphragmatic hernia using observed to expected total fetal lung volume determined by magnetic resonance imaging based on either gestational age or fetal body volume. Ultrasound Obstet Gynecol 32:633–639
Jani J, Cannie M, Done E et al (2007) Relationship between lung area at ultrasound examination and lung volumen assessment with magnetic resonance imaging in isolated congenital diaphragmatic hernia. Ultrasound Obstet Gynecol 30:855–860
Kilian AK, Schaible T, Hofmann V et al (2009) Congenital diaphragmatic hernia: predictive value of MRI relative lung-to-head ratio compared with MRI fetal lung volume and sonographic lung-to-head ratio. AJR 192:153–158
Peralta CF, Jani J, Cos T et al (2006) Left and right lung volumes in fetuses with diaphragmatic hernia. Ultrasound Obstet Gynecol 27:551–554
Jani J, Cannie M, Peralta C et al (2007) Lung volumes in fetuses with congenital diaphragmatic hernia: comparison of 3D US and MR imaging assessments. Radiology 244:575–582
Peralta CF, Kazan-Tannus JF, Bunduki V et al (2006) Evaluation of the agreement between 3-dimensional ultrasonography and magnetic resonance imaging for fetal lung volumen measurement. J Ultrasound Med 25:461–467
Williams G, Coakley F, Qayyum A et al (2004) Fetal relative lung volume: quantification by using prenatal MR imaging lung volumetry. Radiology 233:457–462
Osada H, Kaku K, Masuda K et al (2004) Quantitative and qualitative evaluations of fetal lung with MR imaging. Radiology 231:887–892
Ward VL, Nishino M, Hatabu H et al (2006) Fetal lung volume measurements: determination with MR imaging-effect of various factors. Radiology 240:187–193
Cannie MM, Jani JC, De Keyzer F et al (2006) Fetal body volume: use at MR imaging to quantify relative lung volume in fetuses suspected of having pulmonary hypoplasia. Radiology 241:847–853
Mong A, Johnson AM, Kramer SS et al (2008) Congenital high airway obstruction syndrome: MR/US findings, effect on management, and outcome. Pediatr Radiol 38:1171–1179
Cannie MM, Jani JC, Van Kerkhove F et al (2008) Fetal body volume at MR imaging to quantify total fetal lung volume: normal ranges. Radiology 247:197–203
Cannie M, Jani JC, Chaffiotte C et al (2008) Quantification of intrathoracic liver herniation by magnetic resonance imaging and prediction of postnatal survival in fetuses with congenital diaphragmatic hernia. Ultrasound Obstet Gynecol 32:627–632
Deshmukh S, Rubesova E, Barth R (2010) MR Assessment of normal fetal lung volumes: a literature review. AJR 194:212–217
Fuke S, Kanzaki T, Mu J et al (2003) Antenatal prediction of pulmonary hypoplasia by acceleration time/ejection time ratio of fetal pulmonary arteries by Doppler blood flow velocimetry. Am J Obstet Gynecol 188:228–233
Doné E, Gucciardo L, Van Mieghem T et al (2008) Prenatal diagnosis, prediction of outcome and in utero therapy of isolated congenital diaphragmatic hernia. Prenat Diagn 28:581–591
Sandaite I, Claus F et al (2011) Examining the relationship between the lung-to-head ratio measured on ultrasound and volumetry by magnetic resonance in fetuses with isolated congenital diaphragmatic hernia. Fetal Diagn Ther 29:80–87
Peralta CF, Cavoretto P, Csapo B et al (2005) Assessment of lung area in normal fetuses at 12–32 weeks. Ultrasound Obstet Gynecol 26:718–724
Enriquez G, Aso C, Serres X (2008) In: Lucaya J, Strife JL (eds) Pediatric Chest Imaging. Springer, Berlin Heidelberg, pp 1–35
Chaoui R, Taddei F, Rizzo G et al (1998) Doppler echocardiography of the main stems of the pulmonary arteries in the normal human fetus. Ultrasound Obstet Gynecol 11:173–179
Chaoui R, Kalache K, Tennstedt C et al (1999) Pulmonary arterial Doppler velocimetry in fetuses with lung hypoplasia. Eur J Obstet Gynecol Reprod Biol 84:179–185
Jani J, Nicolaides KH, Benachi A et al (2008) Timing of lung size assessment in the prediction of survival in fetuses with diaphragmatic hernia. Ultrasound Obstet Gynecol 31:37–40
Jani J, Nicolaides KH, Keller RL et al (2007) Observed to expected lung area to head circumference ratio in the prediction of survival in the fetuses with isolated diaphragmatic hernia. Ultrasound Obstet Gynecol 30:67–71
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Castellote, A., Mencho, S., Carreras, E. et al. Correlation between US and MRI for prenatal lung volumetry in diaphragmatic hernia, and use of Doppler to identify the ipsilateral lung cap. Pediatr Radiol 41, 1569–1577 (2011). https://doi.org/10.1007/s00247-011-2200-6
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00247-011-2200-6