Fetal and Perinatal Medicine Research Group, Department of Maternal-Fetal Medicine Hospital Clinic-IDIBAPS, University of Barcelona and Centre for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain.
Ultrasound Obstet Gynecol. 2010 May;35(5):578-82. doi: 10.1002/uog.7592.
To evaluate lung tissue perfusion in fetuses with congenital diaphragmatic hernia (CDH) and to explore the association of lung tissue perfusion with the lung area to head circumference ratio (LHR) and intrapulmonary artery pulsed Doppler.
Fetuses with isolated left CDH were evaluated and compared with a group of fetuses without CDH, which were sampled from our general population and matched by gestational age at inclusion. Lung tissue perfusion measured using fractional moving blood volume (FMBV), the observed to expected (O/E) LHR and pulsed Doppler of the proximal intrapulmonary artery were evaluated in the lung contralateral to the side of the hernia. Doppler waveform analysis included the pulsatility index (PI), the peak early diastolic reversed flow (PEDRF) and the peak systolic velocity (PSV). All Doppler parameters were converted into Z-scores for gestational age. The associations between FMBV and O/E-LHR and between FMBV and intrapulmonary arterial Doppler parameters were analyzed using multiple linear regression, adjusted by gestational age.
A total of 190 fetuses (95 with CDH and 95 controls) were evaluated. Fetuses with CDH showed significantly lower lung FMBV (26.8 (SD 8.4) vs. 37.9 (SD 8.1)%; P < 0.001) than controls. Lung tissue perfusion correlated positively with O/E-LHR (r = 0.37; P < 0.001) and negatively with intrapulmonary artery PI (r = - 0.31; P < 0.001), PEDRF (r = - 0.43; P < 0.001) and PSV (r = - 0.18; P = 0.03).
Fetuses with CDH have decreased lung tissue perfusion, which is associated with decreased lung growth and increased intrapulmonary artery impedance.
评估先天性膈疝（CDH）胎儿的肺组织灌注情况，并探讨肺组织灌注与肺面积与头围比（LHR）和肺内动脉脉冲多普勒的关系。
评估孤立性左侧 CDH 胎儿，并与一组无 CDH 的胎儿进行比较，后者从我们的一般人群中采样，并按纳入时的胎龄匹配。使用分数移动血容量（FMBV）、对侧肺的观察到的与预期的（O/E）LHR 和肺内动脉近端脉冲多普勒评估疝侧肺的肺组织灌注。多普勒波形分析包括搏动指数（PI）、早期舒张反向峰值血流（PEDRF）和收缩期峰值速度（PSV）。所有多普勒参数均转换为与胎龄相关的 Z 分数。使用多元线性回归分析 FMBV 与 O/E-LHR 之间以及 FMBV 与肺内动脉多普勒参数之间的相关性，通过胎龄进行调整。
共评估了 190 例胎儿（95 例 CDH 和 95 例对照）。CDH 胎儿的肺 FMBV 明显低于对照组（26.8（SD 8.4）与 37.9（SD 8.1）%；P<0.001）。肺组织灌注与 O/E-LHR 呈正相关（r=0.37；P<0.001），与肺内动脉 PI（r=-0.31；P<0.001）、PEDRF（r=-0.43；P<0.001）和 PSV（r=-0.18；P=0.03）呈负相关。
CDH 胎儿的肺组织灌注减少，与肺生长减少和肺内动脉阻抗增加有关。
