The contribution of F. Gotsch and R. Romero to this article was prepared as part of their official duties as United States Government employees.
Non-invasive fetal lung assessment using diffusion-weighted imaging
Article first published online: 26 OCT 2009
Copyright © 2009 ISUOG. Published by John Wiley & Sons, Ltd.
Ultrasound in Obstetrics & Gynecology
Volume 34, Issue 6, pages 673–677, December 2009
How to Cite
Lee, W., Krisko, A., Shetty, A., Yeo, L., Hassan, S. S., Gotsch, F., Mody, S., Gonçalves, L. F. and Romero, R. (2009), Non-invasive fetal lung assessment using diffusion-weighted imaging. Ultrasound Obstet Gynecol, 34: 673–677. doi: 10.1002/uog.7446
- Issue published online: 1 DEC 2009
- Article first published online: 26 OCT 2009
- Manuscript Accepted: 3 JUN 2009
- Perinatology Research Branch
- Division of Intramural Research
- Eunice Kennedy Shriver National Institute of Child Health and Human Development
- diffusion-weighted imaging;
- magnetic resonance imaging
The main goal was to develop a reproducible method for estimating the diffusion of water in human fetal lung tissue using diffusion-weighted imaging (DWI). A secondary objective was to determine the relationship of the apparent diffusion coefficients (ADCs) in the fetal lung to menstrual age and total lung volume.
Normal pregnant volunteers were scanned on a 1.5-Tesla (T) magnetic resonance imaging (MRI) system. The MRI system was equipped with 40-mT/m gradients (slew rate 200 T/m/s, rise time 0.2 ms). A six-channel body array coil was used for signal reception. Single-shot DWI utilized TE/TR 125/3400 ms, slice thickness 4 mm, field of view 280 mm × 280 mm, interslice gap 0.8 mm and a matrix of 128 × 128. The voxel size was 2.5 mm × 2.5 mm × 4.0 mm. Two b-values (0 and 1000) were chosen along three orthogonal directions. ADC maps were created using assigned b-values. Simple linear regression was performed with Pearson correlation coefficient. Interexaminer and intraexaminer bias, and 95% limits of agreement (LOA) were determined using Bland–Altman plots.
Forty-seven scans were performed at a mean ± SD of 29.2 ± 4.5 weeks. The median coefficient of variation for ADC was 5.6% (interquartile range, 4.0–8.1%). No differences in ADC values were found between right and left lungs. Normally distributed ADC measurements were not significantly correlated with either total lung volume (r2 = 0.0001, P = 0.94) or menstrual age (r2 = 0.003, P = 0.70). The mean ADC value was 1.75 (95% CI, 1.63–1.86). Mean ± SD intraexaminer bias was −0.15 ± 2.3 (95% LOA, −4.7 to + 4.4) and interexaminer bias was 2.2 ± 3.5 (95% LOA, −4.7 to + 9.1).
Our findings suggest that ADC measurements of the fetal lung are reproducible between blinded examiners and are independent of menstrual age, as well as lung volume. Copyright © 2009 ISUOG. Published by John Wiley & Sons, Ltd.