Prenatal MR imaging of congenital diaphragmatic hernias

• Verfasst von: Henzler, Claudia [VerfasserIn]
• Verfasst von: Zahn, Katrin [VerfasserIn]
• Verfasst von: Weis, Meike [VerfasserIn]
• Verfasst von: Weiß, Christel [VerfasserIn]
• Verfasst von: Schönberg, Stefan [VerfasserIn]
• Verfasst von: Schaible, Thomas [VerfasserIn]
• Verfasst von: Büsing, Karen-Anett [VerfasserIn]
• Verfasst von: Neff, Wolfgang [VerfasserIn]
• Titel: Prenatal MR imaging of congenital diaphragmatic hernias
• Titelzusatz: association of MR fetal lung volume with the need for postnatal prosthetic patch repair
• Verf.angabe: Claudia Hagelstein, Katrin Zahn, Meike Weidner, Christel Weiss, Stefan O. Schoenberg, Thomas Schaible, Karen A. Büsing, K. Wolfgang Neff
• Jahr: 2015
• Umfang: 9 S.
• Fussnoten: Published online: 3 September 2014 ; Gesehen am 06.07.2017
• Titel Quelle: Enthalten in: European radiology
• Ort Quelle: Berlin : Springer, 1991
• Jahr Quelle: 2015
• Band/Heft Quelle: 25(2015), 1, Seite 258-266
• ISSN Quelle: 1432-1084
• ISSN Quelle: 1613-3757
• DOI: doi:10.1007/s00330-014-3410-8
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1560556757

Abstract

Objective: To assess whether the need for postnatal prosthetic patch repair of the diaphragmatic defect in neonates with a congenital diaphragmatic hernia (CDH) is associated with the antenatal measured observed-to-expected magnetic resonance fetal lung volume (o/e MR-FLV). Methods: The o/e MR-FLV was calculated in 247 fetuses with isolated CDH. Logistic regression analysis was used to assess the prognostic value of the individual o/e MR-FLV for association with the need for postnatal patch repair. Results: Seventy-seven percent (77 %) of patients with a CDH (190/247) required prosthetic patch repair and the defect was closed primarily in 23 % (57/247). Patients requiring a patch had a significantly lower o/e MR-FLV (27.7 ± 10.2 %) than patients with primary repair (40.8 ± 13.8 %, p < 0.001, AUC = 0.786). With an o/e MR-FLV of 20 %, 92 % of the patients required patch repair, compared to only 24 % with an o/e MR-FLV of 60 %. The need for a prosthetic patch was further influenced by the fetal liver position (herniation/no herniation) as determined by magnetic resonance imaging (MRI; p < 0.001). Fetal liver position, in addition to the o/e MR-FLV, improves prognostic accuracy (AUC = 0.827). Conclusion: Logistic regression analysis based on the o/e MR-FLV is useful for prenatal estimation of the prosthetic patch requirement in patients with a CDH. In addition to the o/e MR-FLV, the position of the liver as determined by fetal MRI helps improve prognostic accuracy.