Reference Ranges for 2‐Dimensional Sonographic Lung Measurements in Healthy Fetuses

• Published in: Journal of ultrasound in medicine 2014-11, Vol.33 (11), p.1917-1923
• Main Authors: Britto, Ingrid Schwach Werneck, Júnior, Edward Araujo, Sangi-Haghpeykar, Haleh, Bussamra, Luiz Cláudio Silva, Deter, Russell L., Belfort, Michael A., Lee, Wesley, Ruano, Rodrigo
• Format: Article
• Language: English
• Subjects: congenital diaphragmatic hernia; fetal lung; fetal lung area; lung-to-head ratio; obstetric ultrasound; prenatal diagnosis; pulmonary hypoplasia; sonography
• ISSN: 0278-4297; 1550-9613
• DOI: 10.7863/ultra.33.11.1917

Objectives The purpose of this study was to establish reference ranges for 2‐dimensional sonographic measurements of fetal lungs from longitudinal data. Methods A total of 214 fetal lung measurements were longitudinally evaluated in 62 healthy fetuses between 20 and 36 weeks’ menstrual age. Both right and left lung areas were measured in the heart 4‐chamber view using lung area tracing and axis diameter methods. Multilevel modeling was used to evaluate the expected values and variability with respect to menstrual age and to generate reference ranges for the lung area, lung‐to‐head ratio, quantitative lung index, and observed‐to‐expected lung‐to‐head ratio for both lungs. Results The expected values varied with menstrual age for all parameters. Variance was menstrual age dependent for all parameters except the longest diameter area measurements and their lung‐to‐head ratios. Conclusions Models are presented for expected 2‐dimensional sonographic lung size parameters and their variance as a function of menstrual age. These data have been used to generate age‐specific reference ranges for both measurements and indices.