Abstract | OBJECTIVE: MATERIALS AND METHODS: MRI was performed in 96 fetuses (34 females and 62 males; mean gestational age, 33 ± 5 [SD] weeks; range, 23-39 weeks) with CDH and 44 healthy control subjects. FLV and FBV were measured for each fetus by one of three investigators, and we calculated the FLV/FBV ratio. Additionally, a subgroup analysis of growth-restricted fetuses was performed. Logistic regression analysis was used to model the dependence of survival and ECMO requirement on the FLV/FBV ratio. Prognostic accuracy was evaluated by applying the area under the curve (AUC). RESULTS: Seventy-eight of the 96 (81%) fetuses survived and 35 (36%) neonates needed ECMO therapy. The FLV/FBV ratio was significantly higher in fetuses who survived (p < 0.0001; AUC = 0.829). Neonates who received ECMO therapy showed a significantly lower prenatal FLV/FBV ratio (p = 0.0001; AUC = 0.811) than neonates who did not need ECMO therapy. A subgroup analysis (n = 13) showed a trend toward a higher FLV/FBV ratio of survivors in comparison with nonsurvivors (p = 0.065; AUC = 0.875). CONCLUSION: In our study, the MRI-based FLV/FBV ratio was able to predict neonatal survival and ECMO requirement in children with CDH with high accuracy. Unlike other prognostic parameters, FLV/FBV ratio is independent of a reference to a control group and may enhance prognostic accuracy particularly in growth-restricted neonatal patients.
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Authors | Meike Weidner, Claudia Hagelstein, Angelika Debus, Anna Walleyo, Christel Weiss, Stefan O Schoenberg, Thomas Schaible, Karen A Büsing, Sven Kehl, K Wolfgang Neff |
Journal | AJR. American journal of roentgenology
(AJR Am J Roentgenol)
Vol. 202
Issue 6
Pg. 1330-6
(Jun 2014)
ISSN: 1546-3141 [Electronic] United States |
PMID | 24848832
(Publication Type: Journal Article)
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Topics |
- Algorithms
- Body Size
- Female
- Hernia, Diaphragmatic
(diagnosis)
- Hernias, Diaphragmatic, Congenital
- Humans
- Image Interpretation, Computer-Assisted
(methods)
- Imaging, Three-Dimensional
(methods)
- Lung Volume Measurements
(methods)
- Magnetic Resonance Imaging
(methods)
- Male
- Prenatal Diagnosis
(methods)
- Reproducibility of Results
- Sensitivity and Specificity
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