Repetitive MR measurements of lung volume in fetuses with congenital diaphragmatic hernia: individual development of pulmonary hypoplasia during pregnancy and calculation of weekly lung growth rates
Repetitive MR measurements of lung volume in fetuses with congenital diaphragmatic hernia: individual development of pulmonary hypoplasia during pregnancy and calculation of weekly lung growth rates
复制标题
先天性膈疝胎儿肺容量的重复 MR 测量：妊娠期间肺发育不全的个体发育和每周肺生长率的计算
DOI：
10.1007/s00330-013-3011-y
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发表时间：
2014
影响因子：
5.9
通讯作者：
Neff KW
中科院分区：
文献类型：
--
作者：
Hagelstein C;Weidner M;Kilian AK;Debus A;Walleyo A;Schoenberg SO;Schaible T;Kehl S;Büsing KA;Neff KW
目的探讨孤立性先天性横隔疝(CDH)胎儿肺体积(FLV)的个体变化，并在孕期应用系列MR检查计算胎儿肺体积的周生长率。所有胎儿都接受了两次核磁共振检查。结果第一次MRI测量的MR-FLV(o/e)为33.3 ± 12.2%，第二次为29.5 ± 10.9%。61%(54/89)的胎儿o/e MR-FLV在妊娠期间下降，26%(23/89)的胎儿o/e MR-FLV升高，13%(12/89)的胎儿o/e MR-FLV值稳定。第一次和最后一次o/e MR-FLV值与死亡率和新生儿体外膜氧合(ECMO)需求显着相关，分娩时MR-FLV测量具有更高的预测准确性。CDH患者每周肺生长率低于健康胎儿。存活者与死亡者、有无ECMO需求的患者的平均周生长率有显著差异。结论CDH患者妊娠期FLV的个体发展差异极大。在决定产前和产后治疗方案之前，建议进行MR-FLV跟踪测量。关键点·妊娠期先天性隔膜疝气(CDH)的肺发育差异极大。·MRI显示患有先天性隔膜疝气的胎儿肺生长率降低。·最终观察到的与预期的胎儿肺体积提供了最好的预后信息。·在决定治疗方案之前，建议进行后续测量。
ObjectiveTo investigate individual changes in fetal lung volume (FLV) in fetuses with isolated congenital diaphragmatic hernia (CDH) and to calculate weekly growth rates of the FLV using serial MR examinations during pregnancy.MethodsMR-FLV was measured in 89 fetuses with CDH. All fetuses received two MRIs. A mean weekly growth rate of the FLV was determined for each fetus and compared with the growth rate of healthy fetuses.ResultsMean observed-to-expected MR-FLV (o/e MR-FLV) measured at the first MRI was 33.3 ± 12.2 % and 29.5 ± 10.9 % at the second MRI. In 61 % of all fetuses (54/89) the o/e MR-FLV decreased during pregnancy, 26 % (23/89) showed an increase in the o/e MR-FLV and 13 % (12/89) had stable values. First and last o/e MR-FLV values were significantly associated with mortality and neonatal extracorporeal membrane oxygenation (ECMO) requirement with a higher prognostic accuracy of MR-FLV measurements near delivery. Patients with CDH had lower weekly lung growth rates than healthy fetuses. There was a significant difference in the mean weekly growth rate between survivors and non-survivors and patients with and without ECMO requirement.ConclusionIndividual development of FLV in patients with CDH during pregnancy is extremely variable. Follow-up MR-FLV measurements are advisable before deciding upon pre- and postnatal therapeutic options.Key points•Lung development in congenital diaphragmatic hernia (CDH) during pregnancy is extremely variable.•MRI demonstrates that lung growth rate is reduced in fetuses with CDH.•The final observed-to-expected fetal lung volume provides the best prognostic information.•Follow-up measurements are advisable before deciding upon therapeutic options.
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影响因子：
19.7
作者：
Duncan, KR;Gowland, PA;Johnson, IR
通讯作者：
Johnson, IR
先天性膈偏血：肺与头比率的预后价值评估。
DOI：
--
发表时间：
2005
期刊：
J Med Ultrasonics. 32
影响因子：
--
作者：
Yoshimura S;Masuzaki H;Hiraki K;Miura K;Nakayama D;Ishimaru T.
通讯作者：
Ishimaru T.
影响因子：
19.7
作者：
Rypens, F;Metens, T;Eurin, D
通讯作者：
Eurin, D
影响因子：
7.1
作者：
Jani, J.;Cannie, M.;Deprest, J.
通讯作者：
Deprest, J.
影响因子：
19.7
作者：
Debus, Angelika;Hagelstein, Claudia;Buesing, Karen A.
通讯作者：
Buesing, Karen A.