Feasibility of two-dimensional ultrasound shear wave elastography of human fetal lungs and liver: A pilot study - 23/08/19

Doi : 10.1016/j.diii.2019.08.002

N. Mottet ^a,^b,⁎ , C. Cochet ^a, C. Vidal ^c, J.P. Metz ^a, S. Aubry ^d, A. Bourtembourg ^a, A. Eckman-Lacroix ^a, D. Riethmuller ^a, L. Pazart ^c, R. Ramanah ^a,^b
^a Department of Obstetrics and Gynecology, Pôle Mère-Femme, University Hospital of Besançon, University of Franche-Comte, 25000 Besançon, France
^b Nanomedicine Lab, Imagery and Therapeutics, EA4662, University of Franche-Comte, 25000 Besançon, France
^c Centre d’investigation Clinique-Innovation Technologique 1431, INSERM, University Hospital of Besançon, 25000 Besançon, France
^d Department of Musculoskeletal Imaging, University Hospital of Besançon, 25000 Besançon, France

^⁎Corresponding author at: Department of Obstetrics and Gynecology, Hôpital Universitaire de Besançon, boulevard Alexander-Fleming, 25000 Besançon, France.Department of Obstetrics and Gynecology, Hôpital Universitaire de Besançonboulevard Alexander-FlemingBesançon25000France

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Abstract

Purpose

The first aim was to evaluate feasibility and reproducibility of 2-dimensional ultrasound (2D) shear wave elastography (SWE) of human fetal lungs and liver between 24 and 34weeks of gestation. The second aim was to model fetal lung-to-liver elastography ratio (LLE ratio) and to assess its variations according to gestational age and maternal administration of corticosteroids.

Material and methods

2D-SWE examinations were prospectively performed in fetuses of women with an uncomplicated pregnancy (group 1) and fetuses of women with a threatened preterm labor requiring administration of corticosteroids (group 2). Two 2D-SWE examinations were performed at “day 0” and “day 2” in group 1; before and 24hours after a course of corticosteroid in group 2. Three operators performed 2 cycles of 3 measurements on the lung (regions A1, A2, A3) and the liver (regions IV, V, VI). Repeatability and reproducibility of measurements were calculated. The fetal LLE ratio was modeled from the most reproducible regions.

Results

Fifty-five women were enrolled in group 1 and 48 in group 2. For the lung, 8.6% of measurements were considered invalid and 6.9% for the liver. The most reproducible region for the lung was A3 [ICC between 0.70 (95% CI: 0.42–0.85) and 0.78 (95% CI: 0.48–0.90)] and region VI for the liver [ICC between 0.70 (95% CI: 0.40–0.85) and 0.84 (95% CI: 0.60–0.94)]. According to gestational age, a moderate positive linear correlation was found for stiffness values of A3 (R=0.56), V (R=0.46) and VI (R=0.44). LLE ratio values at “day 0” were not different between the two groups but decreased at “day 2” in group 2 (0.2; 95% CI: 0.07–0.34; P<0.001).