MRI and three dimensional ultrasonography in the assessment of pulmonary hypoplasia in fetuses with urinary tract anomalies

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• 作者：Mariam Raafat ^{mariam_raafat@yahoo.com" class="auth_mail" title="E-mail the corresponding author} ; Mona El-Kalioubie ^{monaelkalioubie@yahoo.com" class="auth_mail" title="E-mail the corresponding author} ; Sahar Mahmoud Mansour ; ^{sahar_mnsr@yahoo.com" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Fetal MRI ; Pulmonary hypoplasia ; Three-dimensional ultrasound ; Urinary tract anomalies
• 刊名：The Egyptian Journal of Radiology and Nuclear Medicine
• 出版年：2016
• 出版时间：December 2016
• 年：2016
• 卷：47
• 期：4
• 页码：1753-1764
• 全文大小：2420 K

文摘

To analyze the correlation and agreement between three dimensional (3D) US and MRI in the assessment of pulmonary volumes of fetuses with different types of urinary tract malformations (UTM) and high-risk of pulmonary hypoplasia (PH).

Patients and methods

Thirty-nine fetuses with various UTM, at risk for PH were involved in this cross-sectional study. 3D volume US data sets of the fetal lungs were acquired. The right, left and total lung volumes were calculated separately using the virtual organ computer-aided analysis (VOCAL) method with a 30° rotation. MRI of fetal lung was obtained with assessment of signal intensity and lung volumetry. Comparison between mean lung volumes was performed using unpaired t test. Agreement between the 3D-US and MRI methods was done using Cohen kappa test.

Results

Good agreement was detected between the two methods (Kappa = 0.629, p = 0.001). The measured lung volumes by 3D-US were smaller than those measured by MRI (p > 0.05, non-significant). MRI showed greater specificity, PPV and diagnostic accuracy (100% each) than 3D-US (50%, 88.9% and 90% respectively).

Conclusion

There is a good concordance between 3D-US and MRI in the evaluation of PH in fetuses with UTM. MRI could be reserved for borderline cases of pulmonary hypoplasia and the difficult diagnostic situations.