Fetal MR Lung Volumetry in Congenital Diaphragmatic Hernia (CDH): Prediction of Clinical Outcome and the Need for Extracorporeal Membrane Oxygenation (ECMO)

Autor: K. W. Neff, A. K. Kilian, Thomas Schaible, KA Büsing, E. M. Schuetz
Rok vydání: 2009
Předmět:
Male
medicine.medical_specialty
Pregnancy Trimester
Third
medicine.medical_treatment
Statistics as Topic
Diaphragmatic breathing
Sensitivity and Specificity
Ultrasonography
Prenatal
Extracorporeal Membrane Oxygenation
Imaging
Three-Dimensional
Pregnancy
Reference Values
Risk Factors
Prenatal Diagnosis
Internal medicine
Image Processing
Computer-Assisted
Extracorporeal membrane oxygenation
medicine
Humans
Abnormalities
Multiple
Hernia
Lung volumes
Lung
Survival rate
Hernia
Diaphragmatic
Fourier Analysis
medicine.diagnostic_test
business.industry
Ultrasound
Infant
Newborn
Infant
Congenital diaphragmatic hernia
Magnetic resonance imaging
Organ Size
Prognosis
medicine.disease
Magnetic Resonance Imaging
Surgery
Oxygen
Survival Rate
Liver
Pediatrics
Perinatology and Child Health
Cardiology
Female
Hernias
Diaphragmatic
Congenital
Lung Volume Measurements
business
Zdroj: Klinische Pädiatrie. 221:295-301
ISSN: 1439-3824
0300-8630
DOI: 10.1055/s-0029-1192022
Popis: BACKGROUND Despite the ultrasound (US) based lung-to-head ratio (LHR) and first results of fetal lung volume (FLV) determination in magnetic resonance imaging (MRI), there is no reliable prenatal parameter for the clinical course and outcome of fetuses with congenital diaphragmatic hernia (CDH), in particular for the need of extracorporeal membrane oxygenation (ECMO). PATIENTS AND METHOD MR FLV measurement was evaluated in 36 fetuses with CDH using T2-weighted half-Fourier acquisition single-shot turbo spin echo (HASTE) imaging. FLV and liver herniation, respectively, were correlated with survival and the need for ECMO therapy. A total of 18 healthy fetuses served as controls. MR FLV measurement was applied to predict survival and the need for neonatal ECMO therapy and to assess liver herniation as a prognostic parameter. RESULTS On MRI there was a highly significant correlation of the FLV and patients' survival (p=0.0001) and ECMO requirement, respectively (p=0.0029). Compared to normal controls mean FLV in infants who died was 10% (9.4+/-5.8 ml) and 32% in surviving infants (25+/-9.7 ml). Liver herniation significantly decreased lung volume and negatively impacted clinical outcome (p
Databáze: OpenAIRE
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