Value of prenatal magnetic resonance imaging in the prediction of postnatal outcome in fetuses with diaphragmatic hernia

Jani, Jacques; Cannie, Mieke; Sonigo, P.; Robert, Y.; Moreno, Óscar; Benachi, Alexandra; Vaast, P.; Gratacós, Eduard; Nicolaides, Kypros H.; Deprest, Jan

doi:10.1002/uog.6234

Cited by 170 publications

(95 citation statements)

References 30 publications

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“…In the era of evidence-based medicine, it is important to evaluate the additional value and impact of a new clinical tool on perinatal management before its broader application in clinical practice [2,3,4,5,6,7,8,9]. However, few studies have been able to robustly assess the performance of fetal MRI and its influence on clinical management when compared to ultrasound, as the latter is an operator-dependent tool [2,9,10,11,12].…”

Section: Discussionmentioning

confidence: 99%

“…Assessment of fetal lungs represented 11% of the cases, with the main reason for referral being the subcategory of CDH (79%). Fetal MRI carries advantages in its ability to assess total fetal lung volumes (in particular being able to assess the lung ipsilateral to the diaphragmatic defect), which may help in the prediction of survival [5,6,19]. The main indication for fetal MRI in CDH was to assess the thoracic and abdominal anatomy (including liver position) and to exclude additional anomalies (fig.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, quality assurance to confirm and verify the prenatal diagnosis is important; therefore, correlation of the fetal MRI findings with neonatal outcome or postmortem results is imperative. To practice evidence-based medicine, it remains important to evaluate the additional value of fetal MRI in a clinical setting [2,3,4,5,6,7,8,9]. …”

Section: Introductionmentioning

confidence: 99%

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The Contribution of MRI after Fetal Anomalies Have Been Diagnosed by Ultrasound: Correlation with Postnatal Outcomes

Verburg

Fink

Reidy³

et al. 2015

Fetal Diagn Ther

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Objective: The aim of this study was to investigate the additional value of fetal magnetic resonance imaging (MRI) in the assessment and management of fetuses with abnormal findings on ultrasound. Methods: A total of 257 patients who had fetal MRI following the ultrasound diagnosis of a fetal anomaly, or were at high risk, were included. The patients were grouped by referral category for fetal MRI. Fetal MRI was compared to ultrasound in the detection of anomalies, i.e. whether additional findings were identified and if this changed diagnosis, prognosis and management during pregnancy. Results: Ultrasound findings were confirmed on fetal MRI in 89% of the cases. Additional findings were seen with MRI in 28% of all patients. The diagnosis changed in 21% and the prognosis in 19% of the cases. Perinatal management changed in 8%. The antenatal findings were confirmed in all cases that had a postmortem examination following termination of pregnancy. In all the pregnancies that continued to delivery and for which the postnatal outcome is known, the findings correlated in 97% of the cases. Conclusion: Fetal MRI provided additional detection of fetal anomalies, leading to a change in diagnosis and prognosis in 19% of the cases. Neonatal and postmortem findings mostly confirmed the fetal MRI diagnosis, suggesting it to be a useful tool for clinical decision making in perinatal management.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The Contribution of MRI after Fetal Anomalies Have Been Diagnosed by Ultrasound: Correlation with Postnatal Outcomes

Verburg

Fink

Reidy³

et al. 2015

Fetal Diagn Ther

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“…Anhand dieses Wertes ist eine Einteilung in eine Low-Risk-und eine HighRisk-Gruppe möglich; entsprechend sind die Prognoseaussichten und die Aggressivität der notwendigen Therapie zu wählen [23].…”

Section: Kongenitaler Zwerchfelldefekt (Zwerchfellhernie)unclassified

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2012

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“…In fetuses with other etiologies of pulmonary hypoplasia, such as congenital diaphragmatic hernia, the fetal lung volume estimated on MRI is helpful, although institution specific, in predicting survival and the need for extracorporeal membrane oxygenation. Neonatal survival and short-term outcomes can be predicted based on comparisons with established normal ranges for lung volumes [3,6,7,8,9,10,11,12,13]. If fetal lung volume in the setting of giant cervical teratomas can identify fetuses at risk for lethal pulmonary hypoplasia, we could more accurately counsel our patients on the survival of their fetus.…”

Section: Introductionmentioning

confidence: 99%

Fetal Cervical Teratoma: What Is the Role of Fetal MRI in Predicting Pulmonary Hypoplasia?

Wolfe¹,

Lewis²,

Witte³

et al. 2013

Fetal Diagn Ther

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Objective: To determine whether total fetal lung volumes estimated by MRI could predict lethal pulmonary hypoplasia in a cohort of fetuses with cervical teratomas. Methods: We performed a retrospective cohort study of fetal cervical teratomas from January 1, 2005, through April 1, 2012. The primary outcome was the ability of total lung volumes measured by MRI to predict neonatal mortality specifically due to pulmonary hypoplasia. Measured lung volumes were compared to previously reported normal values. The percent of observed-to-expected lung volume and the percent predicted lung volume were calculated. The positive and negative predictive values were calculated for each variable. Results: Fetal MRI-derived total lung volumes 1 standard deviation below the median for gestational age had a positive predictive value of 100% in predicting lethal pulmonary hypoplasia. Conversely, total lung volumes above this level were uniformly associated with pulmonary survival (100% negative predictive value). Additionally, percent predicted lung volume ≤75.7 and observed-to-expected lung volume ≤68.3 were associated with lethal pulmonary hypoplasia. Conclusion: In this small cohort, MRI-estimated lung volumes were helpful in predicting the presence of pulmonary hypoplasia complicating fetal cervical teratoma.

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Value of prenatal magnetic resonance imaging in the prediction of postnatal outcome in fetuses with diaphragmatic hernia

Abstract: Objectives To investigate the potential value of antenatally determined total fetal lung volume (TFLV) by magnetic resonance imaging (MRI) in the prediction of the postnatal survival in congenital diaphragmatic hernia (CDH). Methods

Cited by 170 publications

References 30 publications

The Contribution of MRI after Fetal Anomalies Have Been Diagnosed by Ultrasound: Correlation with Postnatal Outcomes

The Contribution of MRI after Fetal Anomalies Have Been Diagnosed by Ultrasound: Correlation with Postnatal Outcomes

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Fetal Cervical Teratoma: What Is the Role of Fetal MRI in Predicting Pulmonary Hypoplasia?

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