title: Reliability of the lung to thorax transverse area ratio as a predictive parameter in fetuses with congenital diaphragmatic hernia.
abstract: OBJECTIVE
  An accurate prenatal assessment of the patients' severity is essential for the optimal treatment of individuals with congenital diaphragmatic hernia (CDH). The purpose of this study was to clarify the reliability of the lung to thorax transverse area ratio (L/T) as a prenatal predictive parameter.
  
  
  METHODS
  A multicenter retrospective cohort study was conducted on 114 isolated CDH fetuses with a prenatal diagnosis during the period between 2002 and 2007 at five participating centers in Japan. The relationship between the gestational age and the L/T was analyzed. The most powerful measurement point and accurate cutoff value of the L/T was determined by an analysis of a receiver operating characteristic curve, which was verified by comparing the patients' severity.
  
  
  RESULTS
  There was a negative correlation between the gestational age and the L/T in the non-survivors, and no correlation in the survivors. There were significant differences in the parameters which represented the patients' severity including the respiratory and circulatory status, the surgical findings, and the final outcomes between the groups divided at 0.080 in the minimum value of the L/T during gestation.
  
  
  CONCLUSIONS
  The L/T was not strongly influenced by the gestational age, and it was found to be a reliable prenatal predictive parameter in fetuses with isolated CDH.
authors.affiliation: Department of Pediatric Surgery, Osaka University Graduate School of Medicine, Osaka, 565-0871, Japan. usui@pedsurg.med.osaka-u.ac.jp
authors.forename: Noriaki
authors.initials: N
authors.lastname: Usui
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Kitano
authors.forename: Hiroomi
authors.initials: H
authors.lastname: Okuyama
authors.forename: Mari
authors.initials: M
authors.lastname: Saito
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Morikawa
authors.forename: Hajime
authors.initials: H
authors.lastname: Takayasu
authors.forename: Tomoo
authors.initials: T
authors.lastname: Nakamura
authors.forename: Satoshi
authors.initials: S
authors.lastname: Hayashi
authors.forename: Motoyoshi
authors.initials: M
authors.lastname: Kawataki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ishikawa
authors.forename: Keisuke
authors.initials: K
authors.lastname: Nose
authors.forename: Noboru
authors.initials: N
authors.lastname: Inamura
authors.forename: Kouji
authors.initials: K
authors.lastname: Masumoto
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Sago
mesh_terms: D015331:Cohort Studies; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging; D005325:Fetal Organ Maturity; D005865:Gestational Age; D006548:Hernia, Diaphragmatic / Q000000981:diagnostic imaging; D065630:Hernias, Diaphragmatic, Congenital; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000196:embryology*; D008297:Male; D011237:Predictive Value of Tests; D011247:Pregnancy; D012372:ROC Curve; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D016019:Survival Analysis; D013909:Thorax / Q000000981:diagnostic imaging / Q000196:embryology*; D016216:Ultrasonography, Prenatal / Q000379:methods