Assessment Of Fetal Pulmonary Hypoplasia Using Three-dimensional Ultrasonography

PurposeTo build the reference nomograms of fetal lung volumes throughout gestational age using three-dimensional ultrasonography (3D-US) to evaluate fetuses at high risk of pulmonary hypoplasia.MethodsLeft, right and total lung volumes were assessed by 3D-US in 324 normal singleton fetuses and 6 fetuses at high-risk of pulmonary hypoplasia from 16 to 37 weeks'gestation, using the technique of virtual organ computer-aided analysis (VOCAL) at a rotational step of 30 degrees. The relationships between left, right, and total lung volumes and gestational age in normal fetuses were assessed by correlation and regression analysis. Ultrasound results in fetuses at high risk of pulmonary hypoplasia were also evaluated and compared with the clinical and pathological diagnosis postnatally.ResultsThe right, left, and total lung volumes were statistically correlated with gestational age (P<0.001), with the correlation coefficient (r) 0.966, 0.973 and 0.990, respectively. The best-fit exponential curve regression equations were as follows: left lung volume = 0.207exp (0.143×gestational age); right lung volume = 0.301exp (0.14×gestational age); total lung volume = 0.508exp (0.142×gestational age). Ultrasound diagnosis was consistent with clinical or pathological diagnosis in six abnormal fetuses, of which 4 cases with good prognosis, 1 with postoperative death, and the other ending up pregnancy termination.ConclusionsThe reference nomograms of fetal lung volumes from 16 to 37 weeks'gestation is described by 3D-US, which would be useful for the prenatal prediction of pulmonary hypoplasia.