Abstract：
BACKGROUND: Neonatal chest-Xray (CXR)s are commonly performed as a first line investigation for the evaluation of respiratory complications. Although lung area derived from CXRs correlates well with functional assessments of the neonatal lung, it is not currently utilised in clinical practice, partly due to the lack of reference ranges for CXR-derived lung area in healthy neonates. Advanced MR techniques now enable direct evaluation of both fetal pulmonary volume and area. This study therefore aims to generate reference ranges for pulmonary volume and area in uncomplicated pregnancies, evaluate the correlation between prenatal pulmonary volume and area, as well as to assess the agreement between antenatal MRI-derived and neonatal CXR-derived pulmonary area in a cohort of fetuses that delivered shortly after the antenatal MRI investigation.
METHODS: Fetal MRI datasets were retrospectively analysed from uncomplicated term pregnancies and a preterm cohort that delivered within 72 h of the fetal MRI. All examinations included T2 weighted single-shot turbo spin echo images in multiple planes. In-house pipelines were applied to correct for fetal motion using deformable slice-to-volume reconstruction. An MRI-derived lung area was manually segmented from the average intensity projection (AIP) images generated. Postnatal lung area in the preterm cohort was measured from neonatal CXRs within 24 h of delivery. Pearson correlation coefficient was used to correlate MRI-derived lung volume and area. A two-way absolute agreement was performed between the MRI-derived AIP lung area and CXR-derived lung area.
RESULTS: Datasets from 180 controls and 10 preterm fetuses were suitable for analysis. Mean gestational age at MRI was 28.6 ± 4.2 weeks for controls and 28.7 ± 2.7 weeks for preterm neonates. MRI-derived lung area correlated strongly with lung volumes (p < 0.001). MRI-derived lung area had good agreement with the neonatal CXR-derived lung area in the preterm cohort [both lungs = 0.982].
CONCLUSIONS: MRI-derived pulmonary area correlates well with absolute pulmonary volume and there is good correlation between MRI-derived pulmonary area and postnatal CXR-derived lung area when delivery occurs within a few days of the MRI examination. This may indicate that fetal MRI derived lung area may prove to be useful reference ranges for pulmonary areas derived from CXRs obtained in the perinatal period.
METHODS: Fetal MRI datasets were retrospectively analysed from uncomplicated term pregnancies and a preterm cohort that delivered within 72 h of the fetal MRI. All examinations included T2 weighted single-shot turbo spin echo images in multiple planes. In-house pipelines were applied to correct for fetal motion using deformable slice-to-volume reconstruction. An MRI-derived lung area was manually segmented from the average intensity projection (AIP) images generated. Postnatal lung area in the preterm cohort was measured from neonatal CXRs within 24 h of delivery. Pearson correlation coefficient was used to correlate MRI-derived lung volume and area. A two-way absolute agreement was performed between the MRI-derived AIP lung area and CXR-derived lung area.
RESULTS: Datasets from 180 controls and 10 preterm fetuses were suitable for analysis. Mean gestational age at MRI was 28.6 ± 4.2 weeks for controls and 28.7 ± 2.7 weeks for preterm neonates. MRI-derived lung area correlated strongly with lung volumes (p < 0.001). MRI-derived lung area had good agreement with the neonatal CXR-derived lung area in the preterm cohort [both lungs = 0.982].
CONCLUSIONS: MRI-derived pulmonary area correlates well with absolute pulmonary volume and there is good correlation between MRI-derived pulmonary area and postnatal CXR-derived lung area when delivery occurs within a few days of the MRI examination. This may indicate that fetal MRI derived lung area may prove to be useful reference ranges for pulmonary areas derived from CXRs obtained in the perinatal period.
摘要：
背景：新生儿胸部X线检查（CXR）通常是评估呼吸系统并发症的一线检查。尽管来自CXRs的肺面积与新生儿肺的功能评估密切相关，目前尚未在临床实践中使用，部分原因是健康新生儿缺乏CXR衍生肺面积的参考范围。先进的MR技术现在可以直接评估胎儿的肺体积和面积。因此，这项研究旨在为无并发症妊娠的肺容量和面积生成参考范围。评估产前肺体积与面积的相关性，以及在产前MRI检查后不久分娩的一组胎儿中，评估产前MRI来源的肺面积与新生儿CXR来源的肺面积之间的一致性。
方法：对无并发症的足月妊娠和在胎儿MRI检查72小时内分娩的早产队列的胎儿MRI数据集进行回顾性分析。所有检查包括多个平面中的T2加权单发涡轮自旋回波图像。内部管道用于使用可变形的切片到体积重建来校正胎儿运动。从生成的平均强度投影(AIP)图像中手动分割MRI衍生的肺区域。从分娩后24小时内的新生儿CXR测量早产队列中的出生后肺面积。使用Pearson相关系数来关联MRI衍生的肺体积和面积。在MRI衍生的AIP肺面积和CXR衍生的肺面积之间进行双向绝对一致。
结果：来自180个对照和10个早产胎儿的数据集适用于分析。对照组的MRI平均胎龄为28.6±4.2周，早产儿为28.7±2.7周。MRI来源的肺面积与肺体积密切相关(p<0.001)。在早产队列中，MRI衍生的肺面积与新生儿CXR衍生的肺面积具有良好的一致性[双肺=0.982]。
结论：MRI来源的肺面积与绝对肺体积有很好的相关性，当在MRI检查后几天内分娩时，MRI来源的肺面积与出生后CXR来源的肺面积有很好的相关性。这可能表明胎儿MRI衍生的肺区域可能被证明是围产期获得的CXR衍生的肺区域的有用参考范围。
方法：对无并发症的足月妊娠和在胎儿MRI检查72小时内分娩的早产队列的胎儿MRI数据集进行回顾性分析。所有检查包括多个平面中的T2加权单发涡轮自旋回波图像。内部管道用于使用可变形的切片到体积重建来校正胎儿运动。从生成的平均强度投影(AIP)图像中手动分割MRI衍生的肺区域。从分娩后24小时内的新生儿CXR测量早产队列中的出生后肺面积。使用Pearson相关系数来关联MRI衍生的肺体积和面积。在MRI衍生的AIP肺面积和CXR衍生的肺面积之间进行双向绝对一致。
结果：来自180个对照和10个早产胎儿的数据集适用于分析。对照组的MRI平均胎龄为28.6±4.2周，早产儿为28.7±2.7周。MRI来源的肺面积与肺体积密切相关(p<0.001)。在早产队列中，MRI衍生的肺面积与新生儿CXR衍生的肺面积具有良好的一致性[双肺=0.982]。
结论：MRI来源的肺面积与绝对肺体积有很好的相关性，当在MRI检查后几天内分娩时，MRI来源的肺面积与出生后CXR来源的肺面积有很好的相关性。这可能表明胎儿MRI衍生的肺区域可能被证明是围产期获得的CXR衍生的肺区域的有用参考范围。
