Prenatal sonographic predictors of liver herniation in congenital diaphragmatic hernia.
Prenatal sonographic predictors of liver herniation in congenital diaphragmatic hernia.
复制标题
先天性膈疝肝疝的产前超声预测因素。
DOI：
10.7863/jum.1995.14.7.515
复制
发表时间：
1995
影响因子：
2.3
通讯作者：
N. Adzick
中科院分区：
文献类型：
--
作者：
B. S. Bootstaylor;R. Filly;M. Harrison;N. Adzick
我们对所有患有左侧先天性膈疝的胎儿（n = 25）的产前超声检查进行了回顾性审查，这些胎儿在加州大学旧金山分校胎儿治疗中心接受了宫内缺陷手术修复。弗朗西斯科。选择16名候选人进行分析，以确定可靠的肝疝预测因子。门静脉脐段（门静脉窦）向中线左侧弯曲和门静脉分支向肝左叶外侧段走向或高于动脉嵴是肝疝入胎儿胸腔的最佳预测因子（阳性预测值分别为85%和100%）。如果在后胸或中胸位置观察到胃位置，则胃位置是良好的预测因子（阳性预测值= 100%）。然而，这仅发生在16例病例中的7例（44%）。右肺的可见性信息较少（阳性预测值= 63%）。我们不建议在子宫内一期缝合先天性腹股沟疝时，有超声证据表明肝疝入胎儿胸腔。
We conducted a retrospective review of prenatal sonograms of all fetuses (n = 25) with left sided congenital diaphragmatic hernia undergoing in utero surgical repair of the defect at the University of California, San Francisco, Fetal Treatment Center. Sixteen candidates were selected for analysis to determine reliable predictors of liver herniation. Bowing of the umbilical segment of the portal vein (portal sinus) to the left of midline and coursing of portal branches to the lateral segment of the left hepatic lobe toward or above the diaphragmatic ridge were the best predictors for liver herniation into the fetal thorax (positive predictive values of 85% and 100%, respectively). The stomach position was a good predictor if observed in a posterior or midthoracic location (positive predictive value = 100%). However, this occurred in only 7 of 16 (44%) cases. Visibility of the right lung was less informative (positive predictive value = 63%). We do not recommend in utero primary closure of congenital diaphragmatic hernia when there is sonographic evidence of liver herniation into the fetal thorax.