Literature DB >> 18956430

Value of prenatal magnetic resonance imaging in the prediction of postnatal outcome in fetuses with diaphragmatic hernia.

J Jani1, M Cannie, P Sonigo, Y Robert, O Moreno, A Benachi, P Vaast, E Gratacos, K H Nicolaides, J Deprest.   

Abstract

OBJECTIVES: To investigate the potential value of antenatally determined total fetal lung volume (TFLV) by magnetic resonance imaging (MRI) in the prediction of the postnatal survival in congenital diaphragmatic hernia (CDH).
METHODS: We examined fetuses with isolated CDH, in which MRI was used at 22-38 weeks of gestation to measure TFLV and assess intrathoracic herniation of abdominal viscera, that were liveborn after 30 weeks of gestation and had postnatal follow-up until death or discharge from hospital. Regression analysis was used to investigate the effect on survival of gestational age at diagnosis, observed to expected (o/e) TFLV, intrathoracic herniation of the liver, side of CDH, gestational age at MRI, institution, year and gestational age at delivery. In 76 fetuses measurements of o/e TFLV and the lung area to head circumference ratio (LHR) were performed within 2 weeks of each other; in these cases o/e TFLV and o/e LHR were compared for their prediction of postnatal survival.
RESULTS: In the 148 cases that fulfilled the entry criteria, multiple regression analysis demonstrated that significant predictors of survival were the presence or absence of intrathoracic herniation of the liver and o/e TFLV. The area under the receiver-operating characteristics curves for prediction of postnatal survival from o/e TFLV was 0.786 (standard error, 0.059; P < 0.001) and that from o/e LHR was 0.743 (standard error, 0.069; P = 0.001).
CONCLUSIONS: In the assessment of fetuses with CDH, MRI-based o/e TFLV is useful in the prediction of postnatal survival. (c) 2008 ISUOG. Published by John Wiley & Sons, Ltd.

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Year:  2008        PMID: 18956430     DOI: 10.1002/uog.6234

Source DB:  PubMed          Journal:  Ultrasound Obstet Gynecol        ISSN: 0960-7692            Impact factor:   7.299


  23 in total

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4.  Assessment of lung development in isolated congenital diaphragmatic hernia using signal intensity ratios on fetal MR imaging.

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9.  Repetitive MR measurements of lung volume in fetuses with congenital diaphragmatic hernia: individual development of pulmonary hypoplasia during pregnancy and calculation of weekly lung growth rates.

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Review 10.  Can we improve outcome of congenital diaphragmatic hernia?

Authors:  L van den Hout; I Sluiter; S Gischler; A De Klein; R Rottier; H Ijsselstijn; I Reiss; D Tibboel
Journal:  Pediatr Surg Int       Date:  2009-09       Impact factor: 1.827

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