Takuya Kawaguchi1, Kohei Kawaguchi2, Juma Obayashi2, Kunihide Tanaka2, Kei Ohyama2, Yasuji Seki2, Hideki Nagae2, Shigeyuki Furuta2, Kevin C Pringle3, Hiroaki Kitagawa2. 1. Division of Pediatric Surgery, St. Marianna University School of Medicine, 2-16-1, Sugao, Miyamae-ku, Kawasaki, Kanagawa, 2168511, Japan. t2kawaguchi@marianna-u.ac.jp. 2. Division of Pediatric Surgery, St. Marianna University School of Medicine, 2-16-1, Sugao, Miyamae-ku, Kawasaki, Kanagawa, 2168511, Japan. 3. Department of Obstetrics and Gynecology, School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand.
Abstract
BACKGROUND: In congenital diaphragmatic hernia (CDH), there is pulmonary hypoplasia (PH) and also pulmonary vascular and bronchial abnormalities. Few studies have investigated bronchial maldevelopment in CDH. We evaluated bronchial area (BA) by bronchography in a fetal lamb DH model to develop a measure of PH. METHODS: We created DH in fetal lambs at 75 days gestation, delivering by cesarean section and killing them at term (DH, n = 12). Normal term fetuses provided controls (C, n = 5). We measured total lung volume (TLV) and performed barium bronchography. Using image analysis, BA, total lung area (TLA) and bronchial area/lung area ratio (B/L ratio) were calculated. Student's T test (p < 0.05; significant) and Spearman's correlation coefficient were performed. RESULTS: TLV (ml) was 133.3 ± 41.2 in DH and 326 ± 22.5 in C (p = 0.0000001). TLA (cm2) was 78.8 ± 17.4 in DH and 107.1 ± 10.3 in C (p = 0.006). BA (cm2) was 39.6 ± 11.9 in DH and 52.2 ± 7.7 in C (p = 0.019). The B/L ratio was 0.45 ± 0.06 in DH and 0.49 ± 0.05 in C (p = 0.28). There are correlations in DH between TLV and TLA (r = 0.79), TLV and BA (r = 0.73) and in C between TLV and TLA (r = 0.97) and TLV and BA (r = 0.67). CONCLUSION: It may be possible to assess PH on fetal MRI, given the correlation between TLV and TLA, and TLV and BA.
BACKGROUND: In congenital diaphragmatic hernia (CDH), there is pulmonary hypoplasia (PH) and also pulmonary vascular and bronchial abnormalities. Few studies have investigated bronchial maldevelopment in CDH. We evaluated bronchial area (BA) by bronchography in a fetal lamb DH model to develop a measure of PH. METHODS: We created DH in fetal lambs at 75 days gestation, delivering by cesarean section and killing them at term (DH, n = 12). Normal term fetuses provided controls (C, n = 5). We measured total lung volume (TLV) and performed barium bronchography. Using image analysis, BA, total lung area (TLA) and bronchial area/lung area ratio (B/L ratio) were calculated. Student's T test (p < 0.05; significant) and Spearman's correlation coefficient were performed. RESULTS:TLV (ml) was 133.3 ± 41.2 in DH and 326 ± 22.5 in C (p = 0.0000001). TLA (cm2) was 78.8 ± 17.4 in DH and 107.1 ± 10.3 in C (p = 0.006). BA (cm2) was 39.6 ± 11.9 in DH and 52.2 ± 7.7 in C (p = 0.019). The B/L ratio was 0.45 ± 0.06 in DH and 0.49 ± 0.05 in C (p = 0.28). There are correlations in DH between TLV and TLA (r = 0.79), TLV and BA (r = 0.73) and in C between TLV and TLA (r = 0.97) and TLV and BA (r = 0.67). CONCLUSION: It may be possible to assess PH on fetal MRI, given the correlation between TLV and TLA, and TLV and BA.
Authors: Amanda B Daly; John M Wallis; Zachary D Borg; Ryan W Bonvillain; Bin Deng; Bryan A Ballif; Diane M Jaworski; Gilman B Allen; Daniel J Weiss Journal: Tissue Eng Part A Date: 2011-09-23 Impact factor: 3.845
Authors: Jan Deprest; Paul Brady; Kypros Nicolaides; Alexandra Benachi; Christoph Berg; Joris Vermeesch; Glenn Gardener; Eduard Gratacos Journal: Semin Fetal Neonatal Med Date: 2014-11-11 Impact factor: 3.926
Authors: Michael R Harrison; Roberta L Keller; Samuel B Hawgood; Joseph A Kitterman; Per L Sandberg; Diana L Farmer; Hanmin Lee; Roy A Filly; Jody A Farrell; Craig T Albanese Journal: N Engl J Med Date: 2003-11-13 Impact factor: 91.245