Pulmonary T2* quantification of fetuses with congenital diaphragmatic hernia: a retrospective, case-controlled, MRI pilot study
Avena-Zampieri CL, Uus A, Egloff A, Davidson J, Hutter J, Knight CL, Hall M, Deprez M, Payette K, Rutherford M, Greenough A, Story L (2025)
Publication Type: Journal article
Publication year: 2025
Journal
DOI: 10.1038/s41390-025-04091-0
Abstract
Background: Advanced MRI techniques, motion-correction and T2*-relaxometry, may provide information regarding functional properties of pulmonary tissue. We assessed whether lung volumes and pulmonary T2* values in fetuses with congenital diaphragmatic hernia (CDH) were lower than controls and differed between survivors and non-survivors. Methods: Women with uncomplicated pregnancies (controls) and those with a CDH had a fetal MRI on a 1.5 T imaging system encompassing T2 single shot fast spin echo sequences and gradient echo single shot echo planar sequences providing T2* data. Motion-correction was performed using slice-to-volume reconstruction, T2* maps were generated using in-house pipelines. Lungs were segmented separately using a pre-trained 3D-deep-learning pipeline. Results: Datasets from 33 controls and 12 CDH fetuses were analysed. The mean ± SD gestation at scan was 28.3 ± 4.3 for controls and 27.6 ± 4.9 weeks for CDH cases. CDH lung volumes were lower than controls in both non-survivors and survivors for both lungs combined (5.76 ± 3.59 [cc], mean difference = 15.97, 95% CI: −24.51–−12.9, p < 0.001 and 5.73 ± 2.96 [cc], mean difference = 16, 95% CI: 1.91–11.53, p = 0.008) and for the ipsilateral lung (1.93 ± 2.09 [cc], mean difference = 19.8, 95% CI: −28.48–−16.45, p < 0.001 1.58 ± 1.18 [cc], mean difference=20.15, 95% CI: 5.96–15.97, p < 0.001). Mean pulmonary T2* values were lower in non-survivors in both lungs, the ipsilateral and contralateral lungs compared with the control group (81.83 ± 26.21 ms, mean difference = 31.13, 95% CI: −58.14–−10.32, p = 0.006; 81.05 ± 26.84 ms, mean difference = 31.91, 95% CI: −59.02–−10.82, p = 0.006; 82.62 ± 36.31 ms, mean difference = 30.34, 95% CI: −58.84–−8.25, p = 0.011) but no difference was observed between controls and CDH cases that survived. Conclusions: Mean pulmonary T2* values were lower in CDH fetuses compared to controls and CDH cases who died compared to survivors. Mean pulmonary T2* values may have a prognostic function in CDH fetuses. Impact: This study provides original motion-corrected assessment of the morphologic and functional properties of the ipsilateral and contralateral fetal lungs in the context of CDH. Mean pulmonary T2* values were lower in CDH fetuses compared to controls and in cases who died compared to survivors. Mean pulmonary T2* values may have a role in prognostication. Reduction in pulmonary T2* values in CDH fetuses suggests altered pulmonary development, contributing new insights into antenatal assessment.
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United Kingdom (GB)How to cite
APA:
Avena-Zampieri, C.L., Uus, A., Egloff, A., Davidson, J., Hutter, J., Knight, C.L.,... Story, L. (2025). Pulmonary T2* quantification of fetuses with congenital diaphragmatic hernia: a retrospective, case-controlled, MRI pilot study. Pediatric Research. https://doi.org/10.1038/s41390-025-04091-0
MLA:
Avena-Zampieri, Carla L., et al. "Pulmonary T2* quantification of fetuses with congenital diaphragmatic hernia: a retrospective, case-controlled, MRI pilot study." Pediatric Research (2025).
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