Worley Kevin C, Dashe Jodi S, Barber Robert G, Megison Stephen M, McIntire Donald D, Twickler Diane M
Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX 75390-9032, USA.
Am J Obstet Gynecol. 2009 Mar;200(3):318.e1-6. doi: 10.1016/j.ajog.2008.10.008. Epub 2008 Dec 25.
We sought to use magnetic resonance (MR) imaging (MRI) to estimate percentage of fetal thorax occupied by lung, liver, and other abdominal organs in pregnancies with congenital diaphragmatic hernia (CDH).
This was a retrospective study of pregnancies with isolated CDH referred for MRI between August 2000 and June 2006. Four regions of interest were measured in the axial plane by an investigator blinded to neonatal outcome, and volumes were then calculated. The percentages of thorax occupied by lung, liver, and all herniated organs were then compared with neonatal outcomes.
Fifteen CDH fetuses underwent MRI at a median gestational age of 29 weeks. Liver herniation was found in 93%. When the liver occupied > 20% of the fetal thorax, neonatal deaths were significantly increased. Percentages of lung and other herniated organs were not associated with outcome.
In our MR series of isolated CDH, neonatal deaths were significantly increased when > 20% of the fetal thorax was occupied by liver.
我们试图利用磁共振成像（MRI）来估算先天性膈疝（CDH）妊娠中胎儿胸腔被肺、肝脏及其他腹部器官占据的百分比。
这是一项对2000年8月至2006年6月间因MRI检查而转诊的孤立性CDH妊娠进行的回顾性研究。由一位对新生儿结局不知情的研究人员在轴位平面测量四个感兴趣区域，然后计算体积。随后将肺、肝脏及所有疝出器官在胸腔中所占的百分比与新生儿结局进行比较。
15例CDH胎儿在孕龄中位数为29周时接受了MRI检查。93%的胎儿发现有肝脏疝出。当肝脏占据胎儿胸腔的比例>20%时，新生儿死亡显著增加。肺及其他疝出器官所占的百分比与结局无关。
在我们关于孤立性CDH的MRI系列研究中，当胎儿胸腔>20%被肝脏占据时，新生儿死亡显著增加。
