Prenatal prediction of survival in isolated diaphragmatic hernia using observed to expected total fetal lung volume determined by magnetic resonance imaging based on either gestational age or fetal body volume

Cannie, Mieke; Jani, Jacques; Meersschaert, Joke; Allegaert, Karel; Done, Elise; Marchal, Guy; Deprest, Jan; Dymarkowski, Steven

doi:10.1002/uog.6139

Cited by 127 publications

(78 citation statements)

References 22 publications

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“…This is somewhat surprising since lung volume measurements using prenatal MRI was introduced by Baker et al [21] in 1994. Additionally, for some years now prenatal MRI-based O/E TLV has been used extensively in the prediction of postnatal outcomes in fetuses with other congenital malformations such as CDH [14,16,17]. While O/E TLV in CDH patients is mostly used to predict mortality, survival of GO patients in this study was excellent (94%).…”

Section: Discussionmentioning

confidence: 72%

“…Recently, ultrafast fetal MRI has been shown to be a valuable adjunct in the prenatal diagnosis of a variety of congenital malformations [10,11,12,13]. Further, several studies demonstrated the feasibility of using MRI not only to assess normal fetal lung development, but also to predict mortality and morbidity in fetuses with hypoplastic lungs due to congenital diaphragmatic hernia (CDH) [14,15,16,17]. At present, no data are available on the potential value of total lung volume (TLV), measured by prenatal MRI, in the prediction of outcome in GO fetuses.…”

Section: Introductionmentioning

confidence: 99%

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Fetal MRI-Calculated Total Lung Volumes in the Prediction of Short-Term Outcome in Giant Omphalocele: Preliminary Findings

et al. 2012

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Objective: To determine the value of fetal MRI-calculated total lung volumes (TLV) in the prediction of short-term outcome in patients with giant omphalocele (GO). Material and Methods: We reviewed all cases of GO undergoing fetal MRI after 21 weeks’ gestation and receiving postnatal care at our institution between 2003 and 2010. Observed/expected (O/E) TLV was calculated using age-matched TLV normograms [Radiology 2001;219:236–241]. Postnatal outcomes were stratified based on O/E TLV above or below 50% of expected. Results: Seventeen GO cases fulfilled the entry criteria. The mean age at fetal MRI evaluation was 25.8 ± 4.8 weeks’ gestation. The mean GO TLV (21.0 ± 13.2) was lower than age-matched population norms (p < 0.001), resulting in a mean O/E TLV of 52.3 ± 16.8%. The mean gestational age at delivery was 36.8 ± 1.6 weeks. Overall survival was 94%. Fourteen (88%) infants underwent staged reduction, and 2 underwent silver sulfadiazine treatment and delayed repair. Infants with ≤50% of predicted O/E TLV (n = 11, 65%) had lower Apgar scores at birth (p = 0.03), prolonged ventilatory support (p = 0.004), delayed oral intake (p = 0.03), and longer hospitalization (p = 0.03) compared to patients with ≥50% of expected O/E TLV. Two infants (both O/E TLV <50%) required tracheostomy placement. Conclusion: In the assessment of GO fetuses, MRI-based O/E TLV of <50% was predictive of increased postnatal morbidity.

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Section: Discussionmentioning

confidence: 72%

Section: Introductionmentioning

confidence: 99%

Fetal MRI-Calculated Total Lung Volumes in the Prediction of Short-Term Outcome in Giant Omphalocele: Preliminary Findings

et al. 2012

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“…Total fetal lung volume (TFLV) measured from MRI is considered as the most accurate prognostic factor for neonatal survival [33]. Observed-to-expected TFLV of < 35% has been linked with high neonatal mortality [34]. Mayer et al from the Eurofetus group concluded that the side of diaphragmatic defect, position of the liver, and O/E TFLV, as determined on MRI were predictive of the outcome [35].…”

Section: Fetal Intrathoracic Lesionsmentioning

confidence: 99%

Fetal magnetic resonance imaging and ultrasound

Wataganara

Ebrashy

Aliyu

et al. 2016

Journal of Perinatal Medicine

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Magnetic resonance imaging (MRI) has been increasingly adopted in obstetrics practice in the past three decades. MRI aids prenatal ultrasound and improves diagnostic accuracy for selected maternal and fetal conditions. However, it should be considered only when highquality ultrasound cannot provide certain information that affects the counseling, prenatal intervention, pregnancy course, and delivery plan. Major indications of fetal MRI include, but are not restricted to, morbidly adherent placenta, selected cases of fetal brain anomalies, thoracic lesions (especially in severe congenital diaphragmatic hernia), and soft tissue tumors at head and neck regions of the fetus. For fetal anatomy assessment, a 1.5-Tesla machine with a fast T2-weighted single-shot technique is recommended for image requisition of common fetal abnormalities. Individual judgment needs to be applied when considering usage of a 3-Tesla machine. Gadolinium MRI contrast is not recommended during pregnancy. MRI should be avoided in the first half of pregnancy due to small fetal structures and motion artifacts. Assessment of fetal cerebral cortex can be achieved with MRI in the third trimester. MRI is a viable research tool for noninvasive interrogation of the fetus and the placenta.

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“…Some studies report a significantly higher likelihood of death if the O/E TFLV were < 30-35% (Büsing et al, 2008;Cannie et al, 2008;Bonfils et al, 2006). This measurement is considered, to date, as the most accurate prognostic factor for survival of both left-sided and right-sided CDH (Gerards et al, 2008).…”

Section: Total Lung Volume and Signal Intensity By Mrimentioning

confidence: 99%