title: The relationship between three signs of fetal magnetic resonance imaging and severity of congenital diaphragmatic hernia.
abstract: To seek a simple approach for prenatally classifying congenital diaphragmatic hernia (CDH) severity using fetal magnetic resonance imaging (MRI) markers.
  
  
  
  A retrospective, multicenter study using questionnaires to investigate fetal MRI findings. We included fetuses prenatally diagnosed with isolated left-sided CDH and delivered after 36 weeks of gestation. We focused on three fetal MRI morphological signs: incomplete pulmonary baseline (IPB), liver up (LU) and retrocardiac stomach (RCS). We also evaluated the fetal MRI score defined as the total number of positive signs; the primary outcome was survival at discharge.
  
  
  
  In 256 patients (from 56 institutions), IPB, LU and RCS findings correlated with lower survival: odds ratio (95% confidence interval), 0.16 (0.08 to 0.33); 0.24 (0.12 to 0.51); and 0.14 (0.07 to 0.28); respectively. Patients with higher fetal MRI scores had a higher mortality rate.
  
  
  
  IPB, LU and RCS on fetal MRI are related to CDH severity.
authors.affiliation: Division of Neonatology, Center for Maternal-Neonatal Care, Nagoya University Hospital, Nagoya, Japan.|Department of Pediatrics, Anjo Kosei Hospital, Anjo, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Hattori
authors.affiliation: Division of Neonatology, Center for Maternal-Neonatal Care, Nagoya University Hospital, Nagoya, Japan.
authors.forename: M
authors.identifier: 0000-0001-5217-3219
authors.initials: M
authors.lastname: Hayakawa
authors.affiliation: Division of Neonatology, Center for Maternal-Neonatal Care, Nagoya University Hospital, Nagoya, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Ito
authors.affiliation: Division of Neonatology, Center for Maternal-Neonatal Care, Nagoya University Hospital, Nagoya, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Sato
authors.affiliation: Department of Nursing, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Tamakoshi
authors.affiliation: Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Tokyo, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Kanamori
authors.affiliation: Department of Pediatric Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Okuyama
authors.affiliation: Department of Pediatrics Kindai University, Faculty of Medicine, Osaka-sayama, Osaka, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Inamura
authors.affiliation: Division of Neonatology, Center of Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Takahashi
authors.affiliation: Department of Anesthesiology and Intensive Care, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Fujino
authors.affiliation: Department of Pediatric Surgery, Reproductive and Developmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Taguchi
authors.affiliation: Department of Pediatric Surgery, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Osaka, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Usui
mesh_terms: D005260:Female; D005333:Fetus / Q000000981:diagnostic imaging*; D005865:Gestational Age; D065630:Hernias, Diaphragmatic, Congenital / Q000000981:diagnostic imaging* / Q000401:mortality*; D006801:Humans; D007231:Infant, Newborn; D007564:Japan; D008099:Liver / Q000000981:diagnostic imaging; D016015:Logistic Models; D008168:Lung / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging; D008297:Male; D011247:Pregnancy; D011295:Prenatal Care; D011296:Prenatal Diagnosis / Q000379:methods*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013270:Stomach / Q000000981:diagnostic imaging