Related Experiment Video
Updated: Apr 22, 2026
A Standardized Method for Measuring Internal Lung Surface Area via Mouse Pneumonectomy and Prosthesis Implantation
Published on: July 26, 2017
Fetal lung growth represented by longitudinal changes in MRI-derived fetal lung volume parameters predicts survival
Alan Coleman1, Nisarat Phithakwatchara, Aimen Shaaban
1Cincinnati Fetal Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Division of Pediatric, General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Insights
Fetal lung growth rate in congenital diaphragmatic hernia (CDH) is dynamic. Serial MRI lung volumetry in late gestation predicts neonatal survival and aids in prenatal counseling for CDH management.
Area of Science:
- Medical Imaging
- Fetal Medicine
- Pediatric Surgery
Background:
- Congenital diaphragmatic hernia (CDH) is a severe condition impacting fetal lung development.
- Accurate assessment of pulmonary hypoplasia is crucial for predicting outcomes in isolated left-sided CDH.
- Serial volumetric measurements can offer insights into dynamic lung growth patterns.
Purpose of the Study:
- To evaluate fetal lung growth rate in isolated left-sided CDH using serial MRI-based volumetric measures.
- To determine the predictive capacity of lung volume indices for neonatal survival.
- To assess the changes in lung volume during gestation in fetuses with CDH.
Main Methods:
- Fetal MRI was performed in 47 cases of isolated left-sided CDH at early (22-30 weeks) and late (>30 weeks) gestation.
- Lung volume indices including total lung volume (TLV), observed to expected TLV (o/e TLV), and percentage of predicted lung volume (PPLV) were calculated.
- Change rates (Δ) and relative changes in these indices were analyzed for their association with neonatal survival.
Main Results:
- Total lung volume (TLV), observed to expected TLV (o/e TLV), and percentage of predicted lung volume (PPLV) demonstrated varied changes throughout gestation.
- Late gestational TLV, early and late o/e TLV, and late PPLV were significant predictors of neonatal survival.
- Non-survivors exhibited significantly lower ΔTLV and more negative relative ΔPPLV compared to survivors.
Conclusions:
- Pulmonary hypoplasia in CDH is a dynamic process, potentially worsening in the third trimester.
- Repeated MRI lung volumetry in late gestation provides valuable information on individual fetal lung growth.
- These findings can enhance prenatal counseling and guide perinatal management strategies for CDH.
Objective:
The aim of this study was to evaluate fetal lung growth rate for isolated left-sided congenital diaphragmatic hernia (CDH) using serial magnetic resonance imaging (MRI)-based volumetric measures.
Methods:
Early and late gestational (22-30 and >30 weeks' gestation) lung volumetry was obtained by fetal MRI in 47 cases of isolated left-sided CDH. At both of these time points, lung volume indices, including total lung volume (TLV), observed to expected TLV (o/e TLV), and percentage of predicted lung volume (PPLV) as well as their change rates (Δ) and relative Δ during gestation were calculated and analyzed in regard to their capacity to predict neonatal survival.
Results:
TLV, o/e TLV, and PPLV had various changes during gestation. Late TLV, early and late o/e TLV, and late PPLV were predictive of neonatal survival. Non-survivors had lower ΔTLV and more negative relative ΔPPLV than survivors (1.18 vs 1.85 mL/week, P = 0.004 and -4.15%/week vs -1.95%/week, P = 0.002, respectively).
Conclusions:
The severity of pulmonary hypoplasia is dynamic and can worsen in the third trimester. MRI lung volumetry repeated in late gestation can provide additional information on individual lung growth that may facilitate prenatal counseling and focus perinatal management.
