MR prediction of postnatal outcomes in left-sided congenital diaphragmatic hernia using right lung signal intensity: Comparison with that using right lung volume

• Published in: Journal of magnetic resonance imaging 2009-07, Vol.30 (1), p.112-120
• Main Authors: Nishie, Akihiro, Tajima, Tsuyoshi, Asayama, Yoshiki, Ishigami, Kousei, Hirakawa, Masakazu, Nakayama, Tomohiro, Ushijima, Yasuhiro, Kakihara, Daisuke, Okamoto, Daisuke, Yoshiura, Takashi, Masumoto, Kouji, Taguchi, Tomoaki, Tsukimori, Kiyomi, Tokunaga, Shoji, Irie, Hiroyuki, Yoshimitsu, Kengo, Honda, Hiroshi
• Format: Article
• Language: English
• Subjects: Adult; congenital diaphragmatic hernia; Female; Fetal Death; Hernia, Diaphragmatic - mortality; Hernia, Diaphragmatic - pathology; Hernias, Diaphragmatic, Congenital; Humans; Lung - pathology; lung volume; Lung Volume Measurements - methods; lung-to-liver signal intensity ratio; Magnetic Resonance Imaging - methods; MRI; Observer Variation; Predictive Value of Tests; Pregnancy; Pregnancy Outcome; Prenatal Diagnosis - methods; Prenatal Diagnosis - statistics & numerical data; prognosis; Reproducibility of Results; Sensitivity and Specificity; Survival Analysis
• ISSN: 1053-1807; 1522-2586
• DOI: 10.1002/jmri.21829

Purpose To investigate the validity of the fetal right lung‐to‐liver signal intensity ratio (LLSIR) for prediction of postnatal outcomes in left‐sided congenital diaphragmatic hernia (CDH) Materials and Methods The study included 14 pregnant women who underwent MR exams for evaluation of fetal left‐sided CDH. The fetuses were divided into two groups: Group A (n = 9), alive, and Group B (n = 5), dead. On the basis of the half‐Fourier acquisition single‐shot turbo spin‐echo sequence, LLSIR and the right fetal lung volume (FLV) was calculated. In the control group, a regression analysis was performed to associate LLSIR and right FLV with gestational age. The relative LLSIR and right FLV (the observed/expected LLSIR and right FLV) were compared between Groups A and B. Results The mean relative LLSIR, as well as the mean relative right FLV, of Group A was significantly higher than that of Group B (p = 0.035). Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for the relative LLSIR and the relative right FLV, when the cutoff point was defined as 0.646 and 0.420, were the same and were 88.9%, 80.0%, 88.9%, 80.0%, and 85.7%, respectively. Conclusion The postnatal outcomes in left‐sided CDH may be predicted using the LLSIR. J. Magn. Reson. Imaging 2009;30:112–120. © 2009 Wiley‐Liss, Inc.