Assessment of normal pulmonary development using functional magnetic resonance imaging techniques.
T2*
fetal magnetic resonance imaging
lung development
prenatal prediction
Journal
American journal of obstetrics & gynecology MFM
ISSN: 2589-9333
Titre abrégé: Am J Obstet Gynecol MFM
Pays: United States
ID NLM: 101746609
Informations de publication
Date de publication:
06 2023
06 2023
Historique:
received:
06
01
2023
revised:
10
03
2023
accepted:
13
03
2023
medline:
22
5
2023
pubmed:
19
3
2023
entrez:
18
3
2023
Statut:
ppublish
Résumé
The mainstay of assessment of the fetal lungs in clinical practice is via evaluation of pulmonary size, primarily using 2D ultrasound and more recently with anatomical magnetic resonance imaging. The emergence of advanced magnetic resonance techniques such as T2* relaxometry in combination with the latest motion correction post-processing tools now facilitates assessment of the metabolic activity or perfusion of fetal pulmonary tissue in vivo. This study aimed to characterize normal pulmonary development using T2* relaxometry, accounting for fetal motion across gestation. Datasets from women with uncomplicated pregnancies that delivered at term, were analyzed. All subjects had undergone T2-weighted imaging and T2* relaxometry on a Phillips 3T magnetic resonance imaging system antenatally. T2* relaxometry of the fetal thorax was performed using a gradient echo single-shot echo planar imaging sequence. Following correction for fetal motion using slice-to-volume reconstruction, T2* maps were generated using in-house pipelines. Lungs were manually segmented and mean T2* values calculated for the right and left lungs individually, and for both lungs combined. Lung volumes were generated from the segmented images, and the right and left lungs, as well as both lungs combined were assessed. Eighty-seven datasets were suitable for analysis. The mean gestation at scan was 29.9±4.3 weeks (range: 20.6-38.3) and mean gestation at delivery was 40±1.2 weeks (range: 37.1-42.4). Mean T2* values of the lungs increased over gestation for right and left lungs individually and for both lungs assessed together (P=.003; P=.04; P=.003, respectively). Right, left, and total lung volumes were also strongly correlated with increasing gestational age (P<.001 in all cases). This large study assessed developing lungs using T2* imaging across a wide gestational age range. Mean T2* values increased with gestational age, which may reflect increasing perfusion and metabolic requirements and alterations in tissue composition as gestation advances. In the future, evaluation of findings in fetuses with conditions known to be associated with pulmonary morbidity may lead to enhanced prognostication antenatally, consequently improving counseling and perinatal care planning.
Sections du résumé
BACKGROUND
The mainstay of assessment of the fetal lungs in clinical practice is via evaluation of pulmonary size, primarily using 2D ultrasound and more recently with anatomical magnetic resonance imaging. The emergence of advanced magnetic resonance techniques such as T2* relaxometry in combination with the latest motion correction post-processing tools now facilitates assessment of the metabolic activity or perfusion of fetal pulmonary tissue in vivo.
OBJECTIVE
This study aimed to characterize normal pulmonary development using T2* relaxometry, accounting for fetal motion across gestation.
METHODS
Datasets from women with uncomplicated pregnancies that delivered at term, were analyzed. All subjects had undergone T2-weighted imaging and T2* relaxometry on a Phillips 3T magnetic resonance imaging system antenatally. T2* relaxometry of the fetal thorax was performed using a gradient echo single-shot echo planar imaging sequence. Following correction for fetal motion using slice-to-volume reconstruction, T2* maps were generated using in-house pipelines. Lungs were manually segmented and mean T2* values calculated for the right and left lungs individually, and for both lungs combined. Lung volumes were generated from the segmented images, and the right and left lungs, as well as both lungs combined were assessed.
RESULTS
Eighty-seven datasets were suitable for analysis. The mean gestation at scan was 29.9±4.3 weeks (range: 20.6-38.3) and mean gestation at delivery was 40±1.2 weeks (range: 37.1-42.4). Mean T2* values of the lungs increased over gestation for right and left lungs individually and for both lungs assessed together (P=.003; P=.04; P=.003, respectively). Right, left, and total lung volumes were also strongly correlated with increasing gestational age (P<.001 in all cases).
CONCLUSION
This large study assessed developing lungs using T2* imaging across a wide gestational age range. Mean T2* values increased with gestational age, which may reflect increasing perfusion and metabolic requirements and alterations in tissue composition as gestation advances. In the future, evaluation of findings in fetuses with conditions known to be associated with pulmonary morbidity may lead to enhanced prognostication antenatally, consequently improving counseling and perinatal care planning.
Identifiants
pubmed: 36933803
pii: S2589-9333(23)00077-0
doi: 10.1016/j.ajogmf.2023.100935
pmc: PMC10711505
pii:
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
100935Subventions
Organisme : Department of Health
Pays : United Kingdom
Organisme : Wellcome Trust
ID : 201374/Z/16/Z
Pays : United Kingdom
Organisme : NICHD NIH HHS
ID : U01 HD087202
Pays : United States
Organisme : Wellcome Trust
ID : WT203148/Z/16/Z
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/T018119/1
Pays : United Kingdom
Organisme : Wellcome Trust
Pays : United Kingdom
Informations de copyright
Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.
Références
Radiology. 2008 Apr;247(1):197-203
pubmed: 18258812
Magn Reson Imaging. 2012 Nov;30(9):1323-41
pubmed: 22770690
Prenat Diagn. 2022 May;42(5):628-635
pubmed: 35262959
J Perinatol. 2016 Jun;36 Suppl 2:S3-S11
pubmed: 27225963
Prenat Diagn. 2011 Jul;31(7):705-11
pubmed: 21425299
Magn Reson Med. 2019 Jan;81(1):477-485
pubmed: 30058204
Ultrasound Obstet Gynecol. 2012 May;39(5):495-9
pubmed: 21793083
Prenat Diagn. 2014 Dec;34(13):1289-94
pubmed: 25081823
J Magn Reson Imaging. 2021 Jul;54(1):113-121
pubmed: 33586269
Pediatr Res. 2020 May;87(6):1066-1071
pubmed: 31812155
IEEE Trans Med Imaging. 2020 Sep;39(9):2750-2759
pubmed: 32086200
Cell Tissue Res. 2017 Mar;367(3):427-444
pubmed: 28144783
Ultrason Imaging. 2001 Jan;23(1):39-54
pubmed: 11556802
J Cardiovasc Magn Reson. 2014 Oct 28;16:86
pubmed: 25356834
NMR Biomed. 2021 Apr;34(4):e4475
pubmed: 33480110
J Magn Reson Imaging. 2013 Dec;38(6):1342-5
pubmed: 23576455
Hypertension. 2020 Jun;75(6):1523-1531
pubmed: 32336233
Lancet. 2014 Sep 6;384(9946):857-68
pubmed: 25209487
Haematologica. 2014 Nov;99(11):1647-9
pubmed: 25420279
Radiographics. 2009 Sep-Oct;29(5):1433-49
pubmed: 19755604
AJR Am J Roentgenol. 2018 Aug;211(2):432-438
pubmed: 29894217
Anesthesiology. 2015 Apr;122(4):932-46
pubmed: 25587641
Ultrasound Obstet Gynecol. 2005 Dec;26(7):718-24
pubmed: 16308896
Placenta. 2021 Jan 15;104:138-145
pubmed: 33341490
Radiology. 2004 Feb;230(2):353-8
pubmed: 14699185
Magn Reson Med. 2017 Sep;78(3):909-916
pubmed: 27699879
Magn Reson Med. 2019 Feb;81(2):1191-1204
pubmed: 30242899
BMC Med Imaging. 2021 Feb 22;21(1):34
pubmed: 33618694