title: The MRI findings of the right-sided fetal lung can be used to predict postnatal mortality and the requirement for extracorporeal membrane oxygenation in isolated left-sided congenital diaphragmatic hernia.
abstract: We evaluated whether a correlation existed between fetal pulmonary magnetic resonance imaging (MRI) findings and postnatal mortality, as well as the requirements for extracorporeal membrane oxygenation (ECMO) in infants with prenatally diagnosed, isolated left-sided congenital diaphragmatic hernia (CDH). Twenty-one pregnant women carrying fetuses with CDH underwent 30 MRI scans, and the right-sided fetal lung volume (FLV) was measured. In the control, a regression analysis was performed to associate FLV with gestational age. This yielded a formula that enabled the calculation of the expected right fetal lung volume (ERFLV). In cases with CDH, the right-sided observed FLV/ERFLV (= %RFLV) was compared with both the postnatal mortality and whether ECMO was required. Additionally, we investigated the relationship between the lung shape on MRI (whether there was a complete pulmonary baseline present) and postnatal mortality. The %RFLV was significantly lower in nonsurvivors compared with survivors. Among survivors, the %RFLV was significantly lower in infants who required ECMO compared with those who did not. The pulmonary baseline was completely present in 3 (38%) and 13 (100%) of the nonsurvivors and survivors, respectively. In isolated left-sided CDH, the %RFLV is a good predictor not only of postnatal mortality but also of the requirement for ECMO.
authors.affiliation: Maternity and Perinatal Care Center, Nagoya University Hospital, Nagoya, Aichi-prefecture, 466-8550 Japan. masahaya@med.nagoya-u.ac.jp
authors.forename: Masahiro
authors.initials: M
authors.lastname: Hayakawa
authors.forename: Takahiko
authors.initials: T
authors.lastname: Seo
authors.forename: Atsuo
authors.initials: A
authors.lastname: Itakua
authors.forename: Seiji
authors.initials: S
authors.lastname: Hayashi
authors.forename: Megumi
authors.initials: M
authors.lastname: Miyauchi
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Sato
authors.forename: Akiko
authors.initials: A
authors.lastname: Saito
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nakayama
authors.forename: Koji
authors.initials: K
authors.lastname: Takemoto
authors.forename: Masayuki
authors.initials: M
authors.lastname: Hasegawa
authors.forename: Kenitiro
authors.initials: K
authors.lastname: Kaneko
authors.forename: Mayumi
authors.initials: M
authors.lastname: Okada
authors.forename: Hiromi
authors.initials: H
authors.lastname: Hayakawa
authors.forename: Seiji
authors.initials: S
authors.lastname: Sumigama
authors.forename: Fumitaka
authors.initials: F
authors.lastname: Kikkawa
authors.forename: Hisami
authors.initials: H
authors.lastname: Ando
authors.forename: Seiji
authors.initials: S
authors.lastname: Kojima
mesh_terms: D015199:Extracorporeal Membrane Oxygenation / Q000706:statistics & numerical data*; D005260:Female; D005313:Fetal Death; D005333:Fetus / Q000033:anatomy & histology*; D005865:Gestational Age; D006548:Hernia, Diaphragmatic / Q000628:therapy; D065630:Hernias, Diaphragmatic, Congenital; D006801:Humans; D008168:Lung / Q000033:anatomy & histology* / Q000196:embryology; D008279:Magnetic Resonance Imaging; D010100:Oxygen / Q000378:metabolism; D011237:Predictive Value of Tests; D011247:Pregnancy; D011446:Prospective Studies; D013223:Statistics as Topic; D015996:Survival Rate
chemical_list: D010100:Oxygen