title: Magnetic resonance fetal right lung volumetry and its efficacy in predicting postnatal short-term outcomes of congenital left-sided diaphragmatic hernia.
abstract: OBJECTIVE
  We aimed to investigate whether the ratio of magnetic resonance imaging (MRI)-measured right lung volume (RLV) to ultrasonography-estimated bodyweight (RLV/BW) and observed-to-expected (o/e) RLV are of diagnostic value in predicting postnatal outcomes of left congenital diaphragmatic hernia (CDH).
  
  
  METHODS
  We included 32 CDH patients and 34 control subjects. Manually outlined fetal right lung areas on MRI were multiplied by the slice thickness and added to determine the entire volume. The association between RLV and RLV/BW with gestational age in the controls was examined using regression analysis. RLV/BW and o/e RLV were compared between surviving and non-surviving neonates with CDH.
  
  
  RESULTS
  The expected fetal RLV was derived using the formula RLV (mm(3)) = 1.717 × (gestational weeks)(2.82). In the controls, RLV/BW was nearly constant during the third trimester. The 27 survivors with CDH had a median RLV/BW of 10.7 and a median o/e RLV of 60.0, whereas the five non-surviving neonates had a median RLV/BW of 4.3 and a median o/e RLV of 22.6; the differences were statistically significant.
  
  
  CONCLUSIONS
  Assessment of fetal lungs by MRI volumetry is reliable for clinical use. RLV/BW and o/e RLV are potential predictors of postnatal outcomes of left CDH.
authors.affiliation: Department of Maternal Fetal Medicine, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Japan.
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Hidaka
authors.forename: Keisuke
authors.initials: K
authors.lastname: Ishii
authors.forename: Yoko
authors.initials: Y
authors.lastname: Furutake
authors.forename: Ryo
authors.initials: R
authors.lastname: Yamamoto
authors.forename: Jun
authors.initials: J
authors.lastname: Sasahara
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Mitsuda
mesh_terms: D001724:Birth Weight; D016022:Case-Control Studies; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis*; D020567:Fetal Weight; D005865:Gestational Age; D065630:Hernias, Diaphragmatic, Congenital / Q000150:complications* / Q000473:pathology; D006801:Humans; D007231:Infant, Newborn; D008168:Lung / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D009929:Organ Size; D066087:Perinatal Death / Q000209:etiology; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D012189:Retrospective Studies; D016216:Ultrasonography, Prenatal
keywords: congenital diaphragmatic hernia; lung hypoplasia; magnetic resonance imaging; prognosis; volumetry