Comparison of foetal US and MRI in the characterisation of congenital lung anomalies

• Published in: European journal of radiology Vol. 82; no. 12; pp. e860 - e866
• Main Authors: Alamo, Leonor, Reinberg, Olivier, Vial, Yvan, Gudinchet, François, Meuli, Reto
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier Ireland Ltd 01-12-2013
• Subjects: Complex lung lesions; Congenital lung malformation; Female; Foetal MRI; Foetal US; Humans; Infant, Newborn; Lung - abnormalities; Lung - diagnostic imaging; Lung - pathology; Magnetic Resonance Imaging - methods; Male; Prenatal diagnosis; Radiology; Reproducibility of Results; Sensitivity and Specificity; Ultrasonography, Prenatal - methods; pathologic lung volume; magnetic resonance imaging; congenital pulmonary airway malformation; BPS; CLM; MRI; CDH; CPAM; global lung volume; Complex lung lesions; bronchopulmonary sequestration; CE-CT; ultrasound; GLV; Prenatal diagnosis; Foetal US; Foetal MRI; congenital lung malformation; congenital diaphragmatic hernia; PLV; contrast-enhanced computed tomography; US; Congenital lung malformation
• ISSN: 0720-048X; 1872-7727
• DOI: 10.1016/j.ejrad.2013.09.012

Abstract Objectives To compare the accuracy of prenatal ultrasonography (US) to magnetic resonance imaging (MRI) in the characterisation of congenital lung anomalies, and to assess their agreement with final diagnosis. To evaluate the influence of additional MRI information on therapeutic management. Methods 26 prenatal congenital lung anomalies detected consecutively between 2006 and 2012 were retrospectively evaluated. Lesions were initially observed at prenatal US and further investigated with MRI. Prenatal US and MRI imaging findings, and suggested diagnosis were compared with the final diagnosis, obtained from autopsies (4), pathological evaluation following surgical resection (15) and postnatal imaging studies (7). Results Postnatal diagnoses included 7 congenital pulmonary airway malformations, 8 complex lesions, 7 overinflations, 1 sequestration, 1 bronchogenic cyst, 1 blastoma and 1 bilateral lymphangioma. Suggested prenatal US and MRI diagnosis was correct in 34.6% and 46.2% of patients, respectively, mainly isolated lung lesions with typical imaging findings. Nonspecific imaging findings at US and MRI studies were observed in 38.4% of cases. In 42% of the operated anomalies, pathological dissection revealed the presence of complex anomalies. MRI changed the US diagnosis, but not the further management in 9.7% of the lesions. Conclusions Prenatal US and MRI showed a high accuracy in the diagnosis of isolated congenital lung lesions with typical imaging findings. However, overall characterisation rates were low, because of both a high percentage of complex lesions and of lesions with nonspecific imaging findings. MRI was better than US in characterising complex lesions, but its additional information did not influence therapy decisions.