Three‐dimensional assessment of umbilical vein deviation angle for prediction of liver herniation in left‐sided congenital diaphragmatic hernia

Autor: B. Muto, Alice Suprani, Paolo Volpe, Eleonora Mazzone, Tiziana Fanelli, Tiziana Frusca, C. Del Rossi, Cinzia Magnani, C. Kaihura, Giuseppe Pedrazzi, Tullio Ghi, Andrea Dall'Asta, Enrico Maria Silini, Nicola Volpe
Rok vydání: 2017
Předmět:
Zdroj: Ultrasound in Obstetrics & Gynecology. 51:214-218
ISSN: 1469-0705
0960-7692
DOI: 10.1002/uog.17406
Popis: Objectives To introduce a new sonographic marker of intrathoracic liver herniation in fetuses with left-sided congenital diaphragmatic hernia (CDH). Methods In a consecutive series of fetuses with isolated CDH, an ultrasound volume of the fetal abdomen was acquired. On this volume, offline calculation of the angle formed by the midline of the abdomen (joining the center of the vertebral body to the abdominal insertion of the umbilical cord) and a second line joining the center of the vertebral body to the intra-abdominal convexity of the umbilical vein was carried out to give the umbilical vein deviation angle (UVDA). The UVDA was measured in a group of normal fetuses selected as controls. At follow-up, the presence of liver herniation was investigated in all cases of CDH. UVDA values were compared between the CDH group and controls, and between CDH ‘liver-up’ vs ‘liver-down’ cases. A receiver–operating characteristics (ROC) curve was constructed to identify a cut-off value of the UVDA with the highest accuracy in predicting liver herniation in the CDH group. Results Between 2009 and 2015, 22 cases of left-sided CDH were included in the study group, of which nine cases had liver herniation. Eighty-eight normal fetuses were recruited as controls. The UVDA was significantly higher in the cases vs controls (15.25 ± 7.91° vs 7.68 ± 1.55°; P
Databáze: OpenAIRE
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