Fetal Lung-to-Liver Signal Intensity Ratio at MR Imaging: Development of a Normal Scale and Possible Role in Predicting Pulmonary Hypoplasia in Utero

Abstract

This study provides a normal scale with a 95% prediction interval for LLSIR.

MR prediction of postnatal outcomes in left‐sided congenital diaphragmatic hernia using right lung signal intensity: Comparison with that using right lung volume

“…Therefore, we selected the liver as a reference. In fact, the LLSIR for normal lung also increased with GA in our analysis as well as in a previous study (16). Keller et al (3) reported that the lung/liver SI ratio in cases with thoracic abnormality did not differ significantly from that in the normal population.…”

“…Although the liver seems to be inappropriate as a reference organ, the MR sequence is quite different from ours using T2-weighted imaging, and no evaluation of the SI ratio after 26 weeks of gestation was made. On the other hand, Brewerton et al (16) reported that the LLSIR for normal lung increases with GA on HASTE and that there is a marked difference in LLSIR between normal and hypoplastic lungs at 25 or more weeks of gestation. The SI loss due to a difference in distance from the phased-array coil also can be avoided because the liver is located near the fetal lung.…”

“…And finally, the production of fetal lung fluid, which reflects high signal intensity on HASTE, starts in the second trimester and the interstitium of the lung becomes gradually thinner (22). Therefore, Brewerton et al (16) suggested that a clear distinction between hypoplastic and normal lungs is obtained at 25 weeks of gestation or more. Hypoplastic and normal lungs may show a similar appearance on T2-weighted imaging before 25 weeks of gestation.…”

Assessment of lung development in isolated congenital diaphragmatic hernia using signal intensity ratios on fetal MR imaging

“…Because of the potential of MR imaging to characterise the chemical and structural composition of different tissue types, attempts have been made to use signal intensity measurements on different sequences to assess developmental changes associated with biochemical maturation processes [11][12][13][14].…”

Prediction of postnatal outcomes in congenital diaphragmatic hernia using MRI signal intensity of the fetal lung

“…Low MRI intensity in T2-weighted image is thought to be a sign of pulmonary hypoplasia clinically, 17,18 and animal study also showed it. 19 However, the meaning of MRI signal intensity of the CDH lung remains controversial.…”