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Evaluation of the Agreement Between 3-Dimensional Ultrasonography and Magnetic Resonance Imaging for Fetal Lung Volume Measurement

Departments of Obstetrics and Gynecology (C.F.A.P., V.B., E.M.S., M.Z.) and Radiology (J.F.K.-T., C.C.d.C., G.G.C.), University of São Paulo, Medical School Hospital, São Paulo, Brazil.

Address correspondence to Cleisson Fabio Andrioli Peralta, MD, PhD, Departamento de Obstetricia e Ginecologia, Instituto Central–Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, Avenida Dr Eneas de Carvalho Aguiar 255, 10° Andar, 05403-000 São Paulo-SP, Brazil. E-mail: cfaperalta{at}hotmail.com

Objective. The purpose of this study was to assess the agreement between 3-dimensional ultrasonography (3DUS) and magnetic resonance imaging (MRI) for lung volumetry in fetuses with and without abnormalities associated with lung hypoplasia. Methods. Fifty-nine singleton pregnancies were evaluated. Cases were separated into groups 1 and 2, according to the presence or absence of malformations associated with lung hypoplasia, respectively. Fetal lung volume was calculated by the Virtual Organ Computer-Aided Analysis (VOCAL) program of the 3DUS and the MRI. In both groups, measurements performed with all VOCAL angles were compared among themselves and with those obtained by MRI. Bland-Altman tests and analysis of variance were used for this purpose. Results. In groups 1 and 2, the mean lung volume obtained with each rotation angle of the VOCAL technique was significantly smaller than the mean volume calculated by MRI (P < .001), and the mean volume obtained with the 30° rotation step was significantly smaller than those obtained with the other rotation steps of the VOCAL technique. Bland-Altman tests confirmed this underestimation and showed a broad 95% confidence interval when the VOCAL angles were compared with those of MRI and when the 30° rotation step was compared with the other VOCAL steps. Conclusions. There was a substantial discrepancy between 3DUS and MRI and between the 30° rotation step of the VOCAL technique and the other rotation angles, for lung volume measurement in fetuses with and without abnormalities associated with lung hypoplasia.

Key Words: fetal lung volume • lung hypoplasia • magnetic resonance imaging • 3-dimensional ultrasonography

Abbreviations: MRI, magnetic resonance imaging • 3DUS, 3-dimensional ultrasonography • VOCAL, Virtual Organ Computer-Aided Analysis

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