Prenatal MR imaging of congenital diaphragmatic hernias: association of MR fetal lung volume with the need for postnatal prosthetic patch repair
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 w...
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| Hauptverfasser: | , , , , , , , |
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| Dokumenttyp: | Article (Journal) |
| Sprache: | Englisch |
| Veröffentlicht: |
2015
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| In: |
European radiology
Year: 2015, Jahrgang: 25, Heft: 1, Pages: 258-266 |
| ISSN: | 1432-1084 |
| DOI: | 10.1007/s00330-014-3410-8 |
| Online-Zugang: | Verlag, Volltext: http://dx.doi.org/10.1007/s00330-014-3410-8 Verlag, Volltext: https://link-springer-com.ezproxy.medma.uni-heidelberg.de/article/10.1007/s00330-014-3410-8 
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| Verfasserangaben: | Claudia Hagelstein, Katrin Zahn, Meike Weidner, Christel Weiss, Stefan O. Schoenberg, Thomas Schaible, Karen A. Büsing, K. Wolfgang Neff |
MARC
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| 245 | 1 | 0 | |a Prenatal MR imaging of congenital diaphragmatic hernias |b association of MR fetal lung volume with the need for postnatal prosthetic patch repair |c Claudia Hagelstein, Katrin Zahn, Meike Weidner, Christel Weiss, Stefan O. Schoenberg, Thomas Schaible, Karen A. Büsing, K. Wolfgang Neff |
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| 520 | |a 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. | ||
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