The quantitative lung index: the left lung

Abstract

Objective

We have previously described a gestational age-independent sonographic parameter to assess fetal lung growth in the right lung (right quantitative lung index, or QLI-R). The purpose of this study was to develop a similar sonographic parameter to assess the growth of the left lung in the fetus, independent of gestational age, or QLI-L.

Study design

A new index, the QLI-L was derived using published formulas for the head circumference (HC) and the area of the base of the left lung (LA), with the corresponding percentiles.

Results

Left lung growth can be expressed using the following formula: $\mathrm{QLI}-\mathrm{L}=\frac{{\mathrm{LA}}_{\mathrm{L}}}{{\left(\frac{\mathrm{HC}}{12}\right)}^2}.$

The 50th percentile of the QLI-L remained approximately constant at 1.0 for the GA between 16-32 weeks. A small left lung (<1st percentile) was defined as a QLI-L < 0.5.

Conclusions

Fetal left lung growth can be adequately described independent of gestational age using the QLI-L. Further experience is needed to assess the clinical accuracy of the QLI-L in characterizing fetal left lung growth.

Keywords:

• Quantitative lung index
• congenital diaphragmatic hernia
• lung-to-head ratio
• tracheal occlusion

Acknowledgements

This paper is dedicated to Professor Jorge Koifman of the Colegio Humboldt in Caracas, Venezuela, for his fundamental teachings in Mathematics.

Disclosure statement

No potential conflict of interest was reported by the author(s).