Prediction of survival in fetuses with left-sided congenital diaphragmatic hernia: Which method is better using MRI observed to expected total fetal lung volumes?

被引：0

作者：

Corroenne, Romain ^{[1
,2
]}

Quintanilla, Leticia Benitez ^{[3
,4
]}

Chabolla, Luis Delgadillo ^{[1
,2
]}

Nassr, Ahmed A. ^{[1
,2
]}

Donepudi, Roopali ^{[1
,2
]}

King, Alice ^{[2
,5
]}

Johnson, Rebecca M. ^{[1
,2
]}

Ketwaroo, Pamela ^{[2
,5
]}

Mehollin-Ray, Amy R. ^{[2
,5
,6
,7
]}

Munoz, Jessian L. ^{[3
,4
]}

Belfort, Michael ^{[1
,2
]}

Cortes, Magdalena Sanz ^{[1
,2
]}

机构：

[1] Baylor Coll Med, Dept Obstet & Gynecol, Div Maternal Fetal Med, Houston, TX 77030 USA

[2] Texas Childrens Hosp, Houston, TX 77030 USA

[3] Univ Barcelona, Fetal Med Res Ctr, BCNatal, Hosp Clin, Barcelona 08028, Spain

[4] Univ Barcelona, Hosp St Joan de Deu, Barcelona 08028, Spain

[5] Baylor Coll Med, Dept Pediat Surg, Houston, TX USA

[6] Texas Childrens Hosp, Baylor Coll Med, EB Singleton Dept Radiol, Houston, TX USA

[7] Emory Univ, Sch Med, Dept Radiol, Atlanta, GA USA

来源：

EUROPEAN JOURNAL OF OBSTETRICS & GYNECOLOGY AND REPRODUCTIVE BIOLOGY | 2025年 / 307卷

关键词：

Congenital diaphragmatic hernia; Fetal lung volume; TFLV; Fetal MRI; EXTRACORPOREAL MEMBRANE-OXYGENATION; HEAD CIRCUMFERENCE RATIO; LIVER HERNIATION; ULTRASOUND; OUTCOMES; WEIGHT; BODY; AREA; NEED;

D O I：

10.1016/j.ejogrb.2025.02.032

中图分类号：

R71 [妇产科学];

学科分类号：

100211 ;

摘要：

Objective: The Observed to Expected Total Fetal Lung Volume (O/E-TFLV) ratio, calculated using fetal MRI, is a common method to assess pulmonary hypoplasia severity in congenital diaphragmatic hernia (CDH). However, its accuracy may be affected by uncertain gestational age (GA), inaccurate pregnancy dating, or abnormal fetal growth. This study aimed to evaluate whether GA determined by first-trimester dating or fetal size at imaging affects the ability of O/E-TFLV to predict 6-month survival in fetuses with isolated left-sided CDH. Methods: Retrospective cohort study of fetuses with isolated left-sided CDH. O/E-TFLV was calculated using GA based on CRL (O/E-TFLVGA) or fetal size-determined GA (O/E-TFLVEFW) at the time of MRI. Prediction of survival was evaluated using ROC curves and logistic regression analyses adjusting by CDH severity and liver herniation. Results: Ninety-seven fetuses underwent third-trimester MRI, with seventy-nine (81 %) also having second- trimester MRI. At six months, 80/97 (82.5 %) were alive. No significant differences were observed between O/E-TFLVGA and O/E-TFLVEFW during the second (31.5[2-74]%vs. 31.7[2.5-86]%, p = 0.71) or third trimester (33.6[0.1-134.3]% vs. 31.7[8-105]%, p = 0.55). Higher O/E-TFLVGA and higher O/E-TFLVEFW were associated with higher chances of survival (Second trimester: O/E-TFLVGA: Odds Ratio 1.09 [95 %CI: 1.02-1.20], p = 0.04; O/E-TFLVEFW: 1.10[1.01-1.20], p = 0.04; Third trimester: O/E-TFLVGA: 1.06[1.02-1.16], p = 0.04; O/ETFLVEFW: 1.03[1.01-1.09], p = 0.04). No significant differences were found in predictive accuracy between O/ETFLVGA and O/E-TFLVEFW based on Area Under the Curve (AUC) analysis (Second trimester: p = 0.65; Third trimester: p = 0.72). Conclusion: There were no difference in the prediction of survival in isolated left-sided CDH fetuses using O/ETFLV regardless of the method used to calculate O/E-TFLV.

引用

页码：241 / 246

页数：6

共 35 条

[31] Prediction of chronic lung disease, survival and need for ECMO therapy in infants with congenital diaphragmatic hernia: Additional value of fetal MRI measurements?
Schaible, T.
Buesing, K. A.
Felix, J. F.
Hop, W. C. J.
Zahn, K.
Wessel, L.
Siemer, J.
Neff, K. W.
Tibboel, D.
Reiss, I.
van den Hout, L.
[J]. EUROPEAN JOURNAL OF RADIOLOGY, 2012, 81 (05) : 1076 - 1082
[32] Prediction of mortality and need for neonatal extracorporeal membrane oxygenation in fetuses with congenital diaphragmatic hernia:: Logistic regression analysis based on MRI fetal lung volume measurements
Neff, K. Wolfgang
Kilian, A. Kristina
Schaible, Thomas
Schuetz, Eva-Maria
Buesing, Karen A.
[J]. AMERICAN JOURNAL OF ROENTGENOLOGY, 2007, 189 (06) : 1307 - 1311
[33] Expanded intrathoracic space in fetal cases of isolated congenital diaphragmatic hernia contributes to disparity between percent predicted lung volume and observed to expected total lung volume
Phithakwatchara, Nisarat
Coleman, Alan
Peiro, Jose L.
Lee, Amanda E.
Keswani, Sundeep G.
Kline-Fath, Beth
Lim, Foong-Yen
Shaaban, Aimen F.
[J]. PRENATAL DIAGNOSIS, 2015, 35 (02) : 154 - 159
[34] Effects of 1.5-T versus 3-T magnetic resonance imaging in fetuses: is there a difference in postnatal neurodevelopmental outcome? Evaluation in a fetal population with left-sided congenital diaphragmatic hernia
Danzer, Enrico
Eppley, Elizabeth
Edgar, J. Christopher
Hoffman, Casey
Goldshore, Matthew A.
Adzick, N. Scott
Hedrick, Holly L.
Victoria, Teresa
[J]. PEDIATRIC RADIOLOGY, 2023, 53 (06) : 1085 - 1091
[35] Re-evaluation of lung to thorax transverse area ratio immediately before birth in predicting postnatal short-term outcomes of fetuses with isolated left-sided congenital diaphragmatic hernia: A single center analysis
Kido, Saki
Hidaka, Nobuhiro
Sato, Yuka
Fujita, Yasuyuki
Miyoshi, Kina
Nagata, Kouji
Taguchi, Tomoaki
Kato, Kiyoko
[J]. CONGENITAL ANOMALIES, 2018, 58 (03) : 87 - 92

← 1 2 3 4 →