MR Assessment of Fetal Lung Maturity in Various Congenital Malformations: Review of Technique and Diagnostic Criteria
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- Category: Vol. 85, December 2017
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MR Assessment of Fetal Lung Maturity in Various Congenital Malformations: Review of Technique and Diagnostic Criteria, MONA M. EL-KALIOUBIE, MARIAM R. LOUIS and WESSAM A. EL-ZAYAT
Abstract
Aim: Our aim was to investigate the potential of MRI in prenatal diagnosis of fetal lung maturity in various congenital abnormalities.
Methodology: Twenty controls and 33 fetuses with a variety of conditions at high-risk for Pulmonary Hypoplasia (PH) were involved in this cross-sectional study. MRS was done with assessment of T2 Signal Intensity (SI) of fetal lung and lung volume measurements. Agreement between each MRS diagnostic criterion (volume-try/SI) and neonatal outcome was calculated using kappa test. Sensitivity, specificity, PIV, NPV and diagnostic accuracy were calculated for MR volumetry and $1.
Results: MR volumetry diagnosed PH in 28 (84.8%) out of the 33 fetuses. Fetal lung SI was bright in 5 cases with extrathoracic congenital anomalies (group 1) and 1 fetus with intrathoracic anomalies (group 2), while lungs elicited low 1251 in 17 cases in group 1 and 10 cases in group 2. SI and MR volumetry showed very good and good agreement with post-natal outcome respectively as regards to a diagnosis of PH (Kappa=0.891 and 0.7732 respectively, p<0.0001). SI showed greater specificity, PPV and accuracy (851%, 93.8% and 95.5% respectively) than volumetry (71.4%, 88.2% and 90.9%). They both had similar sensitivity and NPV (100% respectively).
Conclusion: MR has a clear potential in prenatal diagnostics of lung growth and prediction of PH, by combining the two parameters of fetal lung volume and SI.
Key Words: MRI — Fetal — Lung maturity — Congenital malformations.