Quantitative cardiopulmonary magnetic resonance imaging in neonatal congenital diaphragmatic hernia.
Quantitative cardiopulmonary magnetic resonance imaging in neonatal congenital diaphragmatic hernia.
复制标题
新生儿先天性膈疝的定量心肺磁共振成像。
DOI：
10.1007/s00247-022-05384-w
复制
发表时间：
2022
影响因子：
2.3
通讯作者：
Woods,JasonC
中科院分区：
文献类型：
--
作者：
Tkach,JeanA;Higano,NaraS;Taylor,MichaelD;Moore,RyanA;Hossain,Monir;Huang,Guixia;Spielberg,DavidR;Fain,SeanB;Kingma,PaulS;Woods,JasonC
研究背景先天性腹股沟疝（CDH）患儿常伴有肺动脉高压、心功能损害和肺发育不良，并与发病率和死亡率增加有关。目的探讨MRI对CDH患儿心肺血流动力学和功能的定量分析，并探讨其左右肺血流量和肺容量差异的可行性。（孤立的左CDH：4例修复前，7例修复后，3例修复前和修复后; 9例对照）。计算肺动脉血流量、左室偏心指数、心功能和肺容积。使用Wilcoxon秩和检验的连续数据和Fisher精确检验的分类data.ResultsThe右到左的比率肺动脉血流量和肺容量的修复前和修复后CDH与对照组相比，升高（流量：P<0. 005;体积：P<0. 05前/后修复）。结论心脏MRI是一种连续评价危重婴儿心肺血流动力学和功能的有效方法，可用于捕捉肺血流量和肺容量的左右不对称性。
BackgroundPulmonary arterial hypertension, impaired cardiac function and lung hypoplasia are common in infants with congenital diaphragmatic hernia (CDH) and are associated with increased morbidity and mortality. Robust noninvasive methods to quantify these abnormalities in early infancy are lacking.ObjectiveTo determine the feasibility of MRI to quantify cardiopulmonary hemodynamics and function in infants with CDH and to investigate left–right blood flow and lung volume discrepancies.Materials and methodsWe conducted a prospective MRI study of 23 neonates (isolated left CDH: 4 pre-repair, 7 post-repair, 3 pre- and post-repair; and 9 controls) performed on a small-footprint 1.5-tesla (T) scanner. We calculated MRI-based pulmonary arterial blood flow, left ventricular eccentricity index, cardiac function and lung volume. Using the Wilcoxon rank sum test for continuous data and Fisher exact test for categorical data, we made pairwise group comparisons.ResultsThe right-to-left ratios for pulmonary artery blood flow and lung volume were elevated in pre-repair and post-repair CDH versus controls (flow:P<0.005; volume:P<0.05 pre−/post-repair). Eccentricity index at end-systole significantly differed between pre-repair and post-repair CDH (P<0.01) and between pre-repair CDH and controls (P<0.001).ConclusionCardiopulmonary MRI is a viable method to serially evaluate cardiopulmonary hemodynamics and function in critically ill infants and is useful for capturing left–right asymmetries in pulmonary blood flow and lung volume.