Three-dimensional sonographic measurement of contralateral lung volume in fetuses with isolated congenital diaphragmatic hernia.
OBJECTIVE
To use 3-dimensional sonography (3DUS) to measure contralateral lung volume and evaluate the potential of this measurement to predict neonatal outcome in isolated congenital diaphragmatic hernia (CDH).


METHODS
Between January 2002 and December 2004, the contralateral lung volumes of 39 fetuses with isolated CDH were measured via 3DUS using rotational multiplanar imaging. The observed/expected contralateral fetal lung volume ratios (o/e-ContFLVR) were compared with the lung/head ratio (LHR), observed/expected total fetal lung volume ratio (o/e-TotFLVR), and postnatal outcome.


RESULTS
Contralateral lung volumes are less reduced than total lung volumes in CDH. The bias and precision of 3DUS in estimating contralateral lung volumes were 0.99 cm(3) and 1.11 cm(3), respectively, with absolute limits of agreement ranging from -1.19 cm(3) to +3.17 cm(3). The o/e-ContFLVR was significantly lower in neonatal death cases (median, 0.49 cm(3); range, 0.22-0.99 cm(3)) than in survival cases (median, 0.58 cm(3); range, 0.42-0.92 cm(3) [p < 0.01]). Overall accuracy of the o/e-ContFLVR, o/e-TotFLVR, and LHR in predicting neonatal death were 67.7% (21/31), 80.7% (25/31), and 77.4% (24/31), respectively.


CONCLUSIONS
Although o/e-ContFLVR can be precisely measured with 3DUS and can be used to predict neonatal death in CDH, it is less accurate than LHR and o/e-TotFLVR for that purpose.
Ruano
Rodrigo
R
Hopital Necker-Enfants Malades, AP-HP and Université de Paris V, 149 rue de Sèvres, 75015 Cedex 15, Paris, France.
Aubry
Marie-Cécile
MC
Barthe
Bruno
B
Dumez
Yves
Y
Zugaib
Marcelo
M
Benachi
Alexandra
A
D003937:Diagnosis, Differential; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging*; D006548:Hernia, Diaphragmatic / Q000000981:diagnostic imaging* / Q000196:embryology; D065630:Hernias, Diaphragmatic, Congenital; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008168:Lung / Q000000981:diagnostic imaging* / Q000196:embryology / Q000503:physiopathology; D008176:Lung Volume Measurements / Q000379:methods*; D011247:Pregnancy; D015203:Reproducibility of Results; D012189:Retrospective Studies; D016216:Ultrasonography, Prenatal / Q000379:methods*