The Value Of Fetal Prenatal MRI In Predicting Neonatal Respiratory Distress Syndrome

Objectives To explore the value of Predictive value of prenatal MRI of premature fetus in the third trimester of pregnancy in neonatal respiratory distress syndrome(NRDS).Methods All subjects in this study were collected from pregnant women who were hospitalized in the obstetrics department of Jiangxi Maternity and Child Health Hospital from January 2017 to March 2021.A total of 72 cases were collected and included in the study.The age of pregnant women was 31.6±5.3 years old,and the gestational age was 33.5±2.3 weeks.The selected study subjects were all premature fetuses who underwent MRI examination before delivery during the third trimester,and all newborns underwent bedside chest X-ray examination after birth.For prenatal fetuses,the ROI measurement method was used on the T2WI HASTE sequence of the German SIEMENS AVANTO 1.5T MRI to measure and calculate the signal intensity ratios of the fetal lung liver,lung spleen,lung amniotic fluid and lung placenta.For bedside X-rays of newborns,two doctors who have more than five years of experience in bedside X-rays diagnosis of newborns and above will make the imaging diagnosis with and without NRDS,and divide them into NRDS group and non-NRDS group.In the NRDS group,the NRDS group was diagnosed according to the NRDS X-ray chest radiograph.Using SPSS22.0 statistical software,the results are expressed as mean ± standard deviation((?)±s).The NRDS group and the non-NRDS group were tested for homogeneity of variance and then used independent sample t-test for comparative analysis.For uneven variance,the rank sum test was used;for the comparison between the four groups in the NRDS group,a one-way analysis of variance was used,and the pairwise comparison was performed by LSD.analysis.ROC curve analysis was performed to calculate the best cut-off value,sensitivity,and specificity by analyzing the signal intensity ratios that were statistically different between the NRDS group and the non-NRDS group.P<0.05 indicated that the difference was statistically significant.Results Compared with the non-NRDS group,the lung-to-liver signal intensity ratio in the NRDS group was significantly lower(P<0.05);there was no significant difference in the signal intensity ratio of lung spleen,lung amniotic fluid,and lung placenta.In the NRDS group,the lung-to-liver signal intensity ratio gradually decreased with the increase in grade.Grade I lung-to-liver signal intensity was the highest,and Grade Ⅳ was the lowest.There were statistical differences compared to other groups(P<0.05),and there was no statistical difference between Grade II andⅢ groups.Difference(P>0.05).The area under the ROC curve was used to evaluate the predictive effect of lung-liver signal intensity ratio on NRDS.The area under the ROC curve was 0.69(P<0.05),the best cutoff value was 2.425,the sensitivity was 55.6%,and the specificity was 83.3%.Conclusion The fetal lung-to-liver signal intensity ratio in the NRDS group significantly decreased,and as the NRDS level increased,the lung-to-liver signal intensity ratio gradually decreased,providing a noninvasive,convenient,and quantifiable index for prenatal assessment of fetal lung maturity.