Background To investigate the correlation of fetal lung maturity (FLM) and its stiffness obtained by two-dimensional shear wave elastography (2D-SWE) in rabbits. Methods In 50 fetal rabbits (23–30 days gestation), lung and liver elasticity were measured by 2D-SWE. After cesarean section, dipalmitoylphosphatidylcholine (DPPC) concentration in alveolar lavage fluid and lung interstitial ratio were assessed. Partial correlation analysis was then performed to examine the correlation of fetal lung elasticity/lung-to-liver elasticity (LLE) ratio with DPPC content and with interstitial ratio, respectively. Results Fetal lung and liver 2D-SWE measurements showed good consistency. Fetal lung elasticity and LLE ratio were strongly negatively correlated with DPPC (r = −0.866 [95% CI −0.928, −0.757] and −0.840 [−0.914, −0.714], P < 0.001) and slightly reduced after controlling for interstitial ratio (r = −0.727 [−0.848, −0.534] and −0.672 [−0.815, −0.453], P < 0.001). Conversely, strong positive correlations with the interstitial ratio (r = 0.757 [0.580, 0.865] and 0.763 [0.590, 0.869], P < 0.001) decreased to moderate levels after adjusting for DPPC (r = 0.446 [0.151, 0.667] and 0.471 [0.183, 0.685], P < 0.01). Conclusion 2D-SWE may serve as a useful non-invasive tool for predicting FLM in rabbits, providing a basis for further studies on human FLM. Impact <UnorderedList Mark="Bullet"> <ItemContent> Key Message: Two-dimensional shear wave elastography (2-DSWE) correlates strongly with surfactant content in fetal lungs, offering a potential non-invasive biomarker of functional lung maturity to address the clinical need for predicting neonatal respiratory readiness. </ItemContent> <ItemContent> Novelty: We provide the first quantitative evidence that 2D-SWE values reflect biochemical (surfactant) more closely than structural maturation, redefining its role in perinatal assessment. </ItemContent> <ItemContent> Significance & Impact: 2D-SWE may serve as a novel, non-invasive ultrasound modality for assessing fetal lung maturity. These preclinical findings suggest that it might potentially aid in RDS risk assessment, potentially laying a certain foundation for future clinical research. </ItemContent> </UnorderedList>

Two-dimensional ultrasound shear wave elastography: an effective method for assessing fetal rabbit lung maturity

期刊论文
发表日期：

2026年6月16日

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Qingqing Huang,
Xiali Wang,
Yifang He,
Dandan Wang,
Guorong Lyu

摘要

Background

To investigate the correlation of fetal lung maturity (FLM) and its stiffness obtained by two-dimensional shear wave elastography (2D-SWE) in rabbits.

Methods

In 50 fetal rabbits (23–30 days gestation), lung and liver elasticity were measured by 2D-SWE. After cesarean section, dipalmitoylphosphatidylcholine (DPPC) concentration in alveolar lavage fluid and lung interstitial ratio were assessed. Partial correlation analysis was then performed to examine the correlation of fetal lung elasticity/lung-to-liver elasticity (LLE) ratio with DPPC content and with interstitial ratio, respectively.

Results

Fetal lung and liver 2D-SWE measurements showed good consistency. Fetal lung elasticity and LLE ratio were strongly negatively correlated with DPPC (r = −0.866 [95% CI −0.928, −0.757] and −0.840 [−0.914, −0.714], P < 0.001) and slightly reduced after controlling for interstitial ratio (r = −0.727 [−0.848, −0.534] and −0.672 [−0.815, −0.453], P < 0.001). Conversely, strong positive correlations with the interstitial ratio (r = 0.757 [0.580, 0.865] and 0.763 [0.590, 0.869], P < 0.001) decreased to moderate levels after adjusting for DPPC (r = 0.446 [0.151, 0.667] and 0.471 [0.183, 0.685], P < 0.01).

Conclusion

2D-SWE may serve as a useful non-invasive tool for predicting FLM in rabbits, providing a basis for further studies on human FLM.

Impact

Key Message: Two-dimensional shear wave elastography (2-DSWE) correlates strongly with surfactant content in fetal lungs, offering a potential non-invasive biomarker of functional lung maturity to address the clinical need for predicting neonatal respiratory readiness.

Novelty: We provide the first quantitative evidence that 2D-SWE values reflect biochemical (surfactant) more closely than structural maturation, redefining its role in perinatal assessment.

Significance & Impact: 2D-SWE may serve as a novel, non-invasive ultrasound modality for assessing fetal lung maturity. These preclinical findings suggest that it might potentially aid in RDS risk assessment, potentially laying a certain foundation for future clinical research.