Prediction of postnatal outcomes in congenital diaphragmatic hernia using MRI signal intensity of the fetal lung.
OBJECTIVE
Prognostic prediction in prenatally diagnosed congenital diaphragmatic hernia (CDH) is needed. The aim of the study was to evaluate magnetic resonance imaging (MRI) signal intensity of the fetal lung as a predictor of prognosis in CDH.


METHODS
The subjects consisted of 12 fetuses with prenatally diagnosed CDH, who were treated soon after the birth in our institution. They all underwent MRI at 29 to 37 weeks of gestation. The ratio of the lung signal intensity to the spinal fluid signal intensity (L/SF) was calculated using region-of-interest analysis of T2-weighted images. The relationship between L/SF and clinical data was then examined.


RESULTS
L/SF were significantly larger in survivors compared with deaths (0.815 vs 0.614, P<0.05). In survivors, L/SF significantly correlated with duration of tracheal intubation (rs=-0.938, P<0.01).


CONCLUSIONS
L/SF is a unique factor to predict the survival prognosis and likely to quantify the degree of pulmonary hypoplasia in CDH.
Department of Pediatric Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan. kta@cc.rim.or.jp
K
K
Terui
A
A
Omoto
H
H
Osada
T
T
Hishiki
T
T
Saito
Y
Y
Sato
M
M
Nakata
S
S
Komatsu
S
S
Ono
H
H
Yoshida
D002555:Cerebrospinal Fluid; D003964:Diaphragm; D005260:Female; D005333:Fetus / Q000002:abnormalities*; D006548:Hernia, Diaphragmatic / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery; D065630:Hernias, Diaphragmatic, Congenital; D006801:Humans; D007231:Infant, Newborn; D008168:Lung; D008279:Magnetic Resonance Imaging / Q000379:methods*; D019990:Perioperative Care; D011247:Pregnancy; D011296:Prenatal Diagnosis; D011379:Prognosis; D012815:Signal Processing, Computer-Assisted; D016019:Survival Analysis; D019616:Thoracic Surgical Procedures; D016896:Treatment Outcome