10416

FETAL PULMONARY BIOMETRY IN CONGENITAL DIAPHRAGMAL

HERNIA USING MRI

 

Syrkashev E.M., Solopova A.E., Bychenko V.G., Burov A.A.,

Podurovskaya Y.L, Gus A.I.

Purpose.

To evaluate correlation between fetal lung volume indices and mortality rate in postnatal period with determination the most prognostically valuable methods.

Materials and methods. Prospective study based on analysis of MR-imaging and surgical treatment or autopsy data of 71 newborns with congenital diaphragmatic hernia (CDH). All pregnant women underwent MRI to determine the lung to thorax volume ratio (TLV/ThV), lung to fetal body volume ratio (TLV / FBV), observed to expected lung volume (o/e TLV). Roc-curves were performed. Correlation analysis with postnatal data was carried out.

Results. With o/e TLV, Meyers less than 25%, the mortality rate was 91.7%, with TLV/FBV<0.011 - 80.0%, with TLV/ThV<15% - 77.8%. ROC-AUC for o/e TLV ranged from 0.760 (Meyers et al) to 0.794 (Osada et al), for TLV/FBV - 0.725, for TLV/ThV - 0.789. Among survivors negative correlation was found between TLV/ThV and days at the time of enteral feeding (nasogastric tube) (r = -0.554, p <0.001). For TLV/FBV negative correlation was found with the number of days at the time of full enteral feeding (r = -0.550, p <0.001) and the number of bed-days (r = -0.501, p = 0.001). For o/e TLV, Meyers there was negative correlation with days at the time of withdrawal oxygen supply (r = -0.565, p <0.001), extubation (r = -0.587, p <0.001), switching to enteral nutrition (nasogastric tube) (r = -0.654, p <0.001), full enteral feeding (r = -0.716, p <0.001) and number of bed-days (r = -0.626, p <0.001).

Conclusions. Findings suggest to use lung volume indices as predictors of mortality and severity in newborns with CDH.

 

National medical research center for obstetrics, gynecology and perinatology.

Moscow, Russia.

 

Keywords: fetal MRI, congenital diaphragmatic hernia (CDH), fetal lung volume, prenatal imaging, observed to expected fetal lung volume.

 

Corresponding author:  Syrkashev E.M., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript

 

For citation: Syrkashev E.M., Solopova A.E., Bychenko V.G., Burov A.A., Podurovskaya Y.L, Gus A.I. Fetal pulmonary biometry in congenital diaphragmal hernia using MRI. REJR 2020; 10(4):169-178. DOI:10.21569/2222-7415-2020-10-4-169-178.

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Received:       09.06.20 Accepted:     22.09.20