Fetal Head and Neck Masses: MRI Prediction of Significant Morbidity
| Autor: | David T. Schindel, Yin Xi, Angela Beavers, Diane M. Twickler, Patricia C. Santiago-Munoz, Timothy W. Ng, April A. Bailey |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Polyhydramnios medicine.medical_specialty 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Pregnancy Prenatal Diagnosis medicine Humans Radiology Nuclear Medicine and imaging Fetal head reproductive and urinary physiology Retrospective Studies Tracheal Diseases Obstetrics business.industry Pregnancy Outcome General Medicine Magnetic Resonance Imaging Fetal Diseases In utero Neonatal outcomes Head and Neck Neoplasms 030220 oncology & carcinogenesis Female business |
| Zdroj: | AJR. American journal of roentgenology. 212(1) |
| ISSN: | 1546-3141 |
| Popis: | The purpose of this study is to determine which MRI parameters of fetal head and neck masses predict high-morbidity neonatal outcomes, including ex utero intrapartum treatment (EXIT) procedure.This retrospective study (2004-2016) included parameters of polyhydramnios (based on largest vertical pocket), mass effect on the trachea, mass midline extension, and morphologic grade and size of masses. The morbid cohort included those requiring an EXIT procedure, difficult intubation at delivery, or lethal outcome. Predictive modeling with a multivariable logistic regression and ROC analysis was then performed.Of 36 fetuses, five were delivered by EXIT procedures, there was one neonatal death within 12 hours after delivery, and another neonate required multiple intubation attempts. The remaining 29 fetuses were delivered at outside institutions with no interventions or neonatal morbidity. The largest vertical pocket and mass effect on the trachea were selected as independent predictors by the logistic regression. The cross-validated ROC AUC was 0.951 (95% CI, 0.8795-1).The largest vertical pocket measurement and mass effect on the trachea were the most contributory MRI parameters that predicted significant morbidity in fetuses with masses of the face and neck, along with other significant parameters. These parameters predict significant morbid neonatal outcomes, including the need for EXIT procedures. |
| Databáze: | OpenAIRE |
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