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Determination of Fetal Lung Maturity Using Magnetic Resonance Imaging Signal Intensity Measurements

Mills, Megan MD; Winter, Thomas C. MD; Kennedy, Anne M. MBBCh; Woodward, Paula J. MD

doi: 10.1097/RUQ.0000000000000054
Original Research

Purpose: The objective of this study was to determine if magnetic resonance signal intensity measurements can be used to predict gestational age and hence fetal lung maturity.

Methods: This institutional review board–approved study was a retrospective review of 394 fetal magnetic resonance imaging cases from a single institution for the years 2001 to 2011. For each case, T1- and T2-weighted sequences were selected for data collection. A single reviewer obtained 10 regions of interest (when possible) from each scan (fetal lung, fetal liver, fetal muscle, fetal spleen, and maternal urine, for both T1- and T2-weighted sequences). The medical record was searched for relevant information including best estimate of gestational age, Apgar scores, karyotype, and fetal diagnosis. A variety of organ-to-organ ratios and direct organ signal intensity measurements were assessed for correlation with gestational age.

Results: Three hundred thirty-five cases met inclusion criteria with gestational ages ranging from 17 to 39 weeks (mean, 28.6 weeks). A significant relationship between magnetic resonance signal intensity ratios and gestational age was demonstrated on the T2 lung-to-liver, T2 lung-to-spleen, T2 lung-to-muscle, T1 lung-to-liver, and T1 lung-to-spleen ratios (P < 0.05). T2 lung-to-liver and T2 lung-to-muscle demonstrated the strongest relationship with gestational age (best correlation r = 0.483, P < 0.001). T1 lung-to-liver and T1 lung-to-spleen demonstrated inverse relationships with gestational age (r = −0.174 [P = 0.03] and r = −0.236 [P = 0.02], respectively).

Conclusions: A significant correlation between multiple signal intensity ratios and gestational age is demonstrated. However, the large variances preclude a clinically useful relationship.

Abdominal Imaging Section, Department of Diagnostic Radiology, University of Utah Medical Center, Salt Lake City, Utah.

Received for publication July 17, 2013; accepted October 18, 2013.

Conflicts of interest and source of funding: none.

Reprints: Thomas C. Winter, MD, Department of Radiology, University of Utah, 30 N 1900 E RM 1A071 University Hospital, Salt Lake City, UT 84132 (e-mail: thomas.winter@hsc.utah.edu).

© 2014 by Lippincott Williams & Wilkins