Magnetic Resonance Imaging Assessment of Pulmonary Vascularity in Infants with Congenital Diaphragmatic Hernia: A Novel Tool for Direct Assessment of Severity of Pulmonary Hypertension and Hypoplasia
| Autor: | Jose L. Peiro, Foong-Yen Lim, Beth Haberman, Shreyas Arya, Paul S. Kingma, Jessica Beebe, Jason C. Woods, Shanmukha Mukthapuram, Jean A. Tkach |
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| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Hypertension Pulmonary medicine.medical_treatment Severity of Illness Index Pulmonary hypoplasia Vascularity immune system diseases Internal medicine medicine Humans Lung volumes Longitudinal Studies Mechanical ventilation medicine.diagnostic_test business.industry Infant Newborn virus diseases Congenital diaphragmatic hernia Magnetic resonance imaging medicine.disease Magnetic Resonance Imaging Pulmonary hypertension Hypoplasia Case-Control Studies Pediatrics Perinatology and Child Health Cardiology Female medicine.symptom Hernias Diaphragmatic Congenital Lung Volume Measurements business |
| Zdroj: | The Journal of Pediatrics. 239:89-94 |
| ISSN: | 0022-3476 |
| DOI: | 10.1016/j.jpeds.2021.07.059 |
| Popis: | Objectives To assess the feasibility of magnetic resonance imaging (MRI) for postnatal assessment of pulmonary vascularity in infants with congenital diaphragmatic hernia (CDH). Study design Infants with prenatally diagnosed CDH (n = 24) received postnatal pulmonary MRI. Infants with nonpulmonary birth defects served as controls (n = 5). Semiautomatic segmentation was performed to obtain total vascular volume using time of flight images to assess vascularity. Results Average vascular density (vascular volume/lung volume) in control infants was 0.23 ± 0.06 mm3/mm3 compared with 0.18 ± 0.06 mm3/mm3 in infants with CDH is (P = .09). When stratified further based on CDH severity, the difference between control infants and moderate CDH group was statistically significant. (0.23 mm3/mm3 vs 0.15 mm3/mm3, P = .01). Ipsilateral vascular density on MRI in infants with CDH significantly correlated with the prenatal pulmonary hypertensive index (P = .0004, Spearman R = +0.87) and with number of days on mechanical ventilation (P = .04, Spearman R = −0.44), total days on inhaled nitric oxide (P = .02, Spearman R = −0.47), use of epoprostenol for acute pulmonary hypertension (PH) (0.14 mm3/mm3 vs 0.20 mm3/mm3, P = .005), and use of sildenafil for chronic PH (0.15 mm3/mm3 vs 0.19 mm3/mm3, P = .03). Conclusions Our results suggest that postnatal pulmonary vascularity assessed by MRI strongly correlates with prenatal and postnatal markers of PH severity and that pulmonary vascularity may serve as a direct measure of pulmonary vascular hypoplasia in infants with CDH. |
| Databáze: | OpenAIRE |
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