title: Prognostic usefulness of derived T2-weighted fetal magnetic resonance imaging measurements in congenital diaphragmatic hernia.
abstract: OBJECTIVE
  To determine the usefulness of various parameters based on T2-weighted fetal magnetic resonance (MR) imaging measurements of the uninvolved lung for the neonatal prognosis of congenital diaphragmatic hernia (CDH).
  
  
  METHODS
  We used ultrasonography and MR imaging to study 28 fetuses with CDH. We retrospectively analyzed a) on fetal ultrasonography, the observed-to-expected lung to head ratio (O/E LHR) and the position of the liver, and b) on fetal MR imaging, the lung-liver signal ratio (LLSR) and the lungcerebrospinal fluid ratio (L/CSF SR). To determine the prognostic value of these parameters, we compared them with the following postnatal parameters: survival, pulmonary hypertension, need for oxygen supplementation, and need for extracorporeal membrane oxygenation.
  
  
  RESULTS
  We found significant differences between O/E LHR and the need for postnatal extracorporeal membrane oxygenation (P=.033) and postnatal survival (P=.01). We also found significant differences in LLSR between fetuses that survived more than 45 days and those that died within 45 days (1.91 vs. 2.56; P=.039).
  
  
  CONCLUSIONS
  In fetuses with CDH, the LLSR correlates with postnatal survival and can potentially be used as a prognostic parameter in CDH.
authors.affiliation: Departamento de Radiología (CDI), Hospital Clínic , Barcelona, España. Electronic address: msebasti@clinic.ub.es.
authors.forename: C
authors.initials: C
authors.lastname: Sebastià
authors.affiliation: Departamento de Ginecología y Obstetricia (ICGON), Hospital Clínic, Barcelona, España.
authors.forename: O
authors.initials: O
authors.lastname: Gomez
authors.affiliation: Departamento de Radiología (CDI), Hospital Clínic , Barcelona, España.
authors.forename: R
authors.initials: R
authors.lastname: Salvador
authors.affiliation: Departamento de Radiología (CDI), Hospital Clínic , Barcelona, España.
authors.forename: L
authors.initials: L
authors.lastname: Buñesch
authors.affiliation: Departamento de Ginecología y Obstetricia (ICGON), Hospital Clínic, Barcelona, España.
authors.forename: R
authors.initials: R
authors.lastname: Garcia
authors.affiliation: Departamento de Radiología (CDI), Hospital Clínic , Barcelona, España.
authors.forename: C
authors.initials: C
authors.lastname: Nicolau
mesh_terms: D000328:Adult; D005260:Female; D065630:Hernias, Diaphragmatic, Congenital / Q000000981:diagnostic imaging*; D006801:Humans; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging / Q000379:methods; D011247:Pregnancy; D011296:Prenatal Diagnosis; D011379:Prognosis; D012189:Retrospective Studies; D016216:Ultrasonography, Prenatal; D055815:Young Adult
keywords: Congenital diaphragmatic hernia; Diagnóstico prenatal; Doppler ultrasonography; Ecografía Doppler; Feto; Fetus; Hernia diafragmática congénita; Magnetic resonance imaging; Prenatal diagnosis; Resonancia magnética