MRI Lung Volume Prediction of ECMO and Mortality in Congenital Diaphragmatic Hernia.

IF 1.7 3区医学 Q3 OBSTETRICS & GYNECOLOGY

Fetal Diagnosis and Therapy Pub Date : 2026-01-01 Epub Date: 2025-12-03 DOI:10.1159/000549792

Amelia Gavulic, Madelyn Gerken, Philip Stanic, Todd M Jenkins, Monica Wagner, Stefanie Riddle, Laura Galganski, Beth Rymeski

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引用次数: 0

Abstract

Introduction: This study evaluated fetal MRI lung measurements with ECMO use and survival of prenatally diagnosed CDH.

Methods: This was a retrospective chart review of 113 patients from January 2012 to December 2023 with prenatally diagnosed congenital diaphragmatic hernias. Lung measurements from prenatal MRIs, infant ECMO use, and survival were analyzed to determine optimal cut-off value for outcome prediction.

Results: Patients were categorized as mild (10.1%, n = 11), moderate (34.3%, n = 37), and severe (55.6%, n = 60). Mortality was 29.2% (n = 33), and 52.2% (n = 59) required ECMO. Patients undergoing FETO (n = 11) were excluded from statistical analysis. Median change in total lung volume, ipsilateral lung, and contralateral lung from early to late gestation MRI was 15.1 mL (IQR: 9.3-21.7), 1.5 mL (IQR: 0.1-3.1), and 13.4 mL (IQR: 8.1-18.34), respectively. Optimal cut-off values, sensitivity, specificity, positive predictive value, and negative predictive value were calculated for each volume parameter in terms of predicting ECMO use and mortality. Ipsilateral and contralateral lung growth below the cut-off significantly predicted ECMO use (p < 0.05). There was no significance for any cut-offs predicting mortality.

Conclusion: Lung volume growth measured by MRI in prenatally diagnosed CDH may be a useful predictor of ECMO use and mortality.

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先天性膈疝ECMO与死亡率的MRI肺容量预测。

目的：本研究评估使用ECMO的胎儿MRI肺测量和产前诊断的CDH的生存率。方法：回顾性分析2012年1月- 2023年12月产前诊断的先天性膈疝113例。通过分析产前mri肺部测量、婴儿ECMO使用和生存率来确定预测结果的最佳临界值。结果：患者分为轻度（10.1%,n = 11）、中度（34.3%,n = 37）、重度（55.6%,n = 60）。死亡率为29.2% (n = 33), 52.2% （n = 59）需要ECMO。接受FETO的患者（n = 11）被排除在统计分析之外。妊娠早期至妊娠晚期，全肺容积、同侧肺、对侧肺MRI变化中位数分别为15.1 mL （IQR: 9.3 ~ 21.7）、1.5 mL （IQR: 0.1 ~ 3.1）、13.4 mL （IQR: 8.1 ~ 18.34）。计算各容积参数预测ECMO使用和死亡率的最佳临界值、敏感性、特异性、阳性预测值和阴性预测值。同侧和对侧肺生长低于临界值显著预测ECMO使用（p < 0.05）。任何预测死亡率的截断值都没有意义。结论：在产前诊断的CDH中，MRI测量肺体积增长可能是ECMO使用和死亡率的有用预测指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Fetal Diagnosis and Therapy 医学-妇产科学

CiteScore

4.70

自引率

9.10%

发文量

审稿时长

6-12 weeks

期刊介绍： The first journal to focus on the fetus as a patient, ''Fetal Diagnosis and Therapy'' provides a wide range of biomedical specialists with a single source of reports encompassing the common discipline of fetal medicine.