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- Title
Prenatal prognosis of congenital diaphragmatic hernia using magnetic resonance imaging measurement of fetal lung volume.
- Authors
Gorincour, G.; Bouvenot, J.; Mourot, M. G.; Sonigos, P.; Chaumoitre, K.; Garel, C.; Guibaud, L.; Rypens, F.; Avni, F.; Cassart, M.; Maugey- Laulomss, B.; Bouruere-Najean, B.; Brunelles, F.; Durand, C.; Eurin, D.
- Abstract
Objectives To investigate the correlation between fetal lung volume (FLV), measured with magnetic resonance imaging (MRI), and postnatal mortality in newborns with prenatally diagnosed isolated congenital diaphragmatic hernia (CDH). Methods In a 4-year prospective multi center study, 77 fetuses with isolated CDH diagnosed between 20 and 33 necks' gestation underwent fast spin-echo T2- weighted lung MRI. These MRI-FLV measurements were compared with a previously published normative curve obtained in 215 fetuses without thoracoabdominal malformations and with normal ultrasound biometric findings. FLV measurements were correlated with postnatal survival. The mean gestational age at MRI was 31.3 weeks. Results The measured/expected FLV ratio was significantly lower in the newborns with CDH who died compared with those who survived (23.6 ± 12.2 vs. 36.1 ± 13.0, P < 0.001). When the ratio was below 25%, there was a significant decrease in postnatal survival (19% vs. 40.3%, P = 0.008). Survival was significantly lower for neonates when one lung could not be seen by fetal MRI compared with those fetuses with two visible lungs on MRI (17.9% vs. 62.1%, P < 0.001). Conclusion In isolated CDH, FLV measurement by MRI is a good predictor of postnatal mortality due to pulmonary hypoplasia.
- Subjects
PRENATAL care; PRENATAL diagnosis; OBSTETRICAL diagnosis; MAGNETIC resonance imaging; NEWBORN infants
- Publication
Ultrasound in Obstetrics & Gynecology, 2005, Vol 26, Issue 7, p738
- ISSN
0960-7692
- Publication type
Article
- DOI
10.1002/uog.2618