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MRI Calculation of Lung Volumes to Predict Outcome in Fetuses with Genitourinary Abnormalities

¹ All authors: Department of Radiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390-8896.

View larger version (146K): [in a new window]   Fig. 1A —MR images of 20-week fetus with bilateral multicystic dysplastic kidneys. Selected coronal images from single 90-sec acquisition. Total lung volume (TLV) was 6.48 mL and TLV–gestational age ratio was 0.32. This fetus did not survive and had significant pulmonary hypoplasia at pathologic examination. Regions of interest are the areas of right and left (1 and 2) lung fields in A–D.

View larger version (140K): [in a new window]   Fig. 1B —MR images of 20-week fetus with bilateral multicystic dysplastic kidneys. Selected coronal images from single 90-sec acquisition. Total lung volume (TLV) was 6.48 mL and TLV–gestational age ratio was 0.32. This fetus did not survive and had significant pulmonary hypoplasia at pathologic examination. Regions of interest are the areas of right and left (1 and 2) lung fields in A–D.

View larger version (141K): [in a new window]   Fig. 1C —MR images of 20-week fetus with bilateral multicystic dysplastic kidneys. Selected coronal images from single 90-sec acquisition. Total lung volume (TLV) was 6.48 mL and TLV–gestational age ratio was 0.32. This fetus did not survive and had significant pulmonary hypoplasia at pathologic examination. Regions of interest are the areas of right and left (1 and 2) lung fields in A–D.

View larger version (141K): [in a new window]   Fig. 1D —MR images of 20-week fetus with bilateral multicystic dysplastic kidneys. Selected coronal images from single 90-sec acquisition. Total lung volume (TLV) was 6.48 mL and TLV–gestational age ratio was 0.32. This fetus did not survive and had significant pulmonary hypoplasia at pathologic examination. Regions of interest are the areas of right and left (1 and 2) lung fields in A–D.

View larger version (107K): [in a new window]   Fig. 2A —MR images of 31-week fetus with bladder outlet obstruction. Selected axial images from single 90-sec acquisition. Total lung volume (TLV) was 40.7 mL and TLV–gestational age ratio was 1.31. This fetus survived. Regions of interest are the areas of right and left (1 and 2) lung fields in A–D.

View larger version (112K): [in a new window]   Fig. 2B —MR images of 31-week fetus with bladder outlet obstruction. Selected axial images from single 90-sec acquisition. Total lung volume (TLV) was 40.7 mL and TLV–gestational age ratio was 1.31. This fetus survived. Regions of interest are the areas of right and left (1 and 2) lung fields in A–D.

View larger version (112K): [in a new window]   Fig. 2C —MR images of 31-week fetus with bladder outlet obstruction. Selected axial images from single 90-sec acquisition. Total lung volume (TLV) was 40.7 mL and TLV–gestational age ratio was 1.31. This fetus survived. Regions of interest are the areas of right and left (1 and 2) lung fields in A–D.

View larger version (109K): [in a new window]   Fig. 2D —MR images of 31-week fetus with bladder outlet obstruction. Selected axial images from single 90-sec acquisition. Total lung volume (TLV) was 40.7 mL and TLV–gestational age ratio was 1.31. This fetus survived. Regions of interest are the areas of right and left (1 and 2) lung fields in A–D.

View larger version (4K): [in a new window]   Fig. 3 —Box-and-whisker plot shows distribution of total lung volume–gestational age ratio in survivor and nonsurvivor outcomes with 95% confidence intervals (brackets).

View larger version (5K): [in a new window]   Fig. 4 —Graph shows slopes of total lung volume by gestational age for survivor (upper slope, •) and nonsurvivor (lower slope,) outcomes. Dotted slopes indicate 95% confidence intervals. Hypothesis of equal slopes was rejected (p = 0.0054, analysis of covariance).

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