Assessment of BOLD response in the fetal lung
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PAEDIATRIC
Assessment of BOLD response in the fetal lung Naziha Khen-Dunlop 1,2,3 & Gihad Chalouhi 2 & Augustin Lecler 2 & Afef Bouchouicha 2 & Anne-Elodie Millischer 1,4 & Bertrand Tavitian 2,5 & Nathalie Siauve 1,2,6 & Daniel Balvay 2 & Laurent J Salomon 1,7 Received: 3 January 2020 / Revised: 8 July 2020 / Accepted: 8 September 2020 # European Society of Radiology 2020
Abstract Objective Assessment of lung development and maturity is of utmost importance in prenatal counseling. Blood oxygen level– dependent (BOLD) effect MRI was developed for functional evaluations of organs. To date, no data are available in fetal lungs and nothing is known about the existence of a BOLD effect in the lungs. The aim of our study was to evaluate if a BOLD response could be detected in fetal lungs. Materials and methods From January 2014 to December 2016, 38 healthy pregnant women were prospectively enrolled. After a routine scan on a 1.5-T MRI device (normoxic period), maternal hyperoxia was induced for 5 min before the BOLD sequence (hyperoxic period). R2* was evaluated by fitting average intensity of the signal, both for normoxic (norm) and hyperoxic (hyper) periods. Results A significant BOLD response was observed after maternal hyperoxia in the lungs with a mean R2* decrease of 12.1 ± 2.5% (p < 0.001), in line with the placenta response with a mean R2* decrease of 19.2 ± 5.9% (p < 0.0001), confirming appropriate oxygen uptake. Conversely, no significant BOLD effect was observed for the brain nor the liver with a mean ΔR2* of 3.6 ± 3.1% (p = 0.64) and 2.8 ± 3.7% (p = 0.23). Conclusion This study shows for the first time in human that a BOLD response can be observed in the normal fetal lung despite its prenatal “non-functional status.” If confirmed in congenital lung and chest malformations, this property could be used in addition to the lung volume for a better prediction of postnatal respiratory status. Key Points • Blood oxygen level–dependent (BOLD) effect MRI was developed for functional evaluations of organs and could have interesting implications for the fetal organs. • Assessment of lung development is of utmost importance in prenatal counseling, but to date no data are available in fetal lungs. • BOLD response can be observed in the normal fetal lung opening the way to studies on fetus with pathological lungs. Keywords Thorax . Pregnancy . Respiratory insufficiency
Abbreviations BOLD Blood oxygen level–dependent GA Gestational age LHR Lung-to-head ratio MRI Magnetic resonance imaging
ROI SEM TE TR
* Naziha Khen-Dunlop [email protected]
4
Department of Pediatric Radiology, Necker-Enfants Malades Hospital, Paris, France
5
Department of Radiology, Georges Pompidou European Hospital, Paris Descartes Medical University, Paris, France
6
Department of Radiology, Louis Mourier Hospital, Colombes, France
7
Department of Obstetrics, Necker-Enfants Malades Hospital, Paris, France
1
EA FETUS and LUMIERE PLATEFORM – Faculte Paris Descartes, Paris, France
2
Laboratoire de Recherche en Imagerie (LRI), INSERM
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