title: Expanded intrathoracic space in fetal cases of isolated congenital diaphragmatic hernia contributes to disparity between percent predicted lung volume and observed to expected total lung volume.
abstract: OBJECTIVE
  The aim of this study was to determine whether fetal lung volume and visceral herniation are associated with changes in intrathoracic space in congenital diaphragmatic hernia(CDH).
  
  
  METHODS
  We retrospectively examined the relationship between magnetic resonance imaging-derived measurements of intrathoracic space [predicted lung volume (PLV)] and residual lung volume or visceral herniation among isolated left-sided CDH fetuses.
  
  
  RESULTS
  Data from fetal magnetic resonance imaging studies of 60 isolated left-sided CDH cases were analyzed. The median PLV of the CDH fetuses was found to be much greater than the expected total lung volume (eTLV) of a normal fetus at the same gestational age. Surprisingly, liver herniation and observed TLV(oTLV) were positively correlated with the PLV. Although the PPLV was consistently less than the o/eTLV, both indices were greater in survivors than in non-survivors, whereas no significant difference was seen in the PLV/eTLV ratio in regard to survivorship.
  
  
  CONCLUSIONS
  The intrathoracic domain available for lungs and viscera is expanded in CDH fetuses and positively affected by the lung volume and the presence of liver herniation, leading to the difference in the PPLV and o/eTLV. Future study of intrathoracic space as it relates to the growth of the lung and herniated viscera is needed to better characterize the relationship between these parameters.
authors.affiliation: Cincinnati Fetal Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Bangkok, Thailand.
authors.forename: Nisarat
authors.initials: N
authors.lastname: Phithakwatchara
authors.forename: Alan
authors.initials: A
authors.lastname: Coleman
authors.forename: Jose L
authors.initials: JL
authors.lastname: Peiro
authors.forename: Amanda E
authors.initials: AE
authors.lastname: Lee
authors.forename: Sundeep G
authors.initials: SG
authors.lastname: Keswani
authors.forename: Beth
authors.initials: B
authors.lastname: Kline-Fath
authors.forename: Foong-Yen
authors.initials: FY
authors.lastname: Lim
authors.forename: Aimen F
authors.initials: AF
authors.lastname: Shaaban
mesh_terms: D000328:Adult; D005260:Female; D005333:Fetus / Q000473:pathology; D065630:Hernias, Diaphragmatic, Congenital / Q000401:mortality / Q000473:pathology*; D006801:Humans; D008099:Liver / Q000473:pathology; D008168:Lung / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D009820:Ohio / Q000453:epidemiology; D009929:Organ Size; D011247:Pregnancy; D012189:Retrospective Studies; D035423:Thoracic Cavity / Q000473:pathology*; D055815:Young Adult