总肺体积、肺-肝信号强度比及ADC值评价胎儿肺成熟度的应用价值  

Application value of lung volume,signal intensity ratio of lung to liver and ADC value in evaluating fetal lung maturity

作　　者：何永财 严杰文 曾亦如 崔运能[1] HE Yongcai;YAN Jiewen;ZENG Yiru;CUI Yunneng(Department of Radiology,Foshan Women and Chilren Hospital,Foshan 528099,China)

机构地区：[1]广东省佛山市妇幼保健院放射科,广东佛山528099

出　　处：《中国中西医结合影像学杂志》2023年第5期558-561,570,共5页Chinese Imaging Journal of Integrated Traditional and Western Medicine

基　　金：2022年佛山市自筹经费类科技计划项目(2220001003769);2019年佛山市医学影像精准诊断工程技术研究中心资助项目(FSOAA_KJ819-4901-0049)。

摘　　要：目的:探讨基于MRI测量总肺体积、肺-肝信号强度比及肺平均ADC值评价胎儿肺成熟度的应用价值。方法:收集42例26~39周的胎儿,均行肺部MRI扫描,包括轴位及冠状位单激发自选回波序列(SSFSE)、轴位T_(1)WI和DWI;分别测量并计算出胎儿总肺体积、肺-肝信号强度比及肺平均ADC值,分析其与胎龄的相关性;比较两肺体积及ADC值的差异。结果:42例胎儿,总肺体积26.33~110.74 cm~3,平均(42.46±16.58)cm~3,与胎龄呈正相关(r=0.615,P<0.001)。左、右肺平均体积分别为(26.40±8.94)cm~3、(34.34±11.10)cm~3,差异有统计学意义(t=-11.26,P<0.001)。肺-肝信号强度比为1.45~5.34,平均2.90±0.95,与胎龄呈正相关(r=0.671,P<0.001)。肺ADC值为(1.54~3.23)×10^(-3)mm~2/s,平均(2.91±0.37)×10^(-3)mm~2/s,与胎龄无相关性(P=0.685)。左、右肺平均ADC值分别为(2.51±0.48)×10^(-3)mm~2/s、(2.31±0.50)×10^(-3)mm~2/s,差异无统计学意义(P=0.211)。结论:产前MRI可通过测量胎儿总肺体积及肺-肝信号强度比评价胎儿肺发育成熟度,而肺平均ADC值尚不能作为评价肺发育成熟度的一项参数。Objective:To explore the application value of total lung volume,lung-to-liver signal intensity ratio and ADC value based on MR imaging based on MRI for evaluating the fetal lung maturity.Methods:Forty-two fetuses with 26~39 weeks gestation were collected.All fetuses underwent lung MRI scanning,including axial and coronal SSFSE,axial T_(1)WI and DWI sequence.The fetal total lung volume,lung-to-liver signal intensity ratio and ADC value were measured and calculated.The correlation of the parameters and gestational age was analyzed,and the differences between the two lung volumes and ADC values were compared.Results:The total lung volume of 42 fetuses ranged from 26.33 to 10.74 cm3,with an average of(42.46±16.58)cm3,which was positively correlated with gestational age(r=0.615,P<0.001).The average volumes of the left and right lungs were(26.40±8.94)cm3 and(34.34±11.10)cm3,respectively,and the difference was statistically significant(t=-11.26,P<0.001).The lung-to-liver signal intensity ratio was 1.45~5.34,with an average of(2.90±0.95),which was positively correlated with gestational age(r=0.671,P<0.001).The lung ADC value ranged from 1.54 to 3.23 mm2/s,with an average of(2.91±0.37)×10-3 mm2/s,which was not correlated with gestational age(P=0.685).The average ADC values of the left and right lung were(2.51±0.48)×10-3 mm2/s and(2.31±0.50)×10-3 mm2/s,and the difference was not statistically significant(P=0.211).Conclusions:Prenatal MRI can evaluate fetal lung maturity by measuring the total lung volume and the lung-to-liver signal intensity ratio.While the average ADC value of the lung cannot be used as a parameter to evaluate the lung maturity.

关 键 词：胎儿 肺发育 磁共振成像 表观扩散系数 

分 类 号：R714.5[医药卫生—妇产科学]