Department of Radiology, University Hospitals Leuven, Herestraat 49, Leuven, Belgium.
Radiology. 2010 Oct;257(1):226-32. doi: 10.1148/radiol.10092388. Epub 2010 Aug 16.
To measure tracheal dimensions in children with congenital diaphragmatic hernia (CDH) who had undergone fetoscopic endoluminal tracheal occlusion (FETO) or were treated expectantly during gestation.
The study was approved by the local ethics committee. Computed tomography was performed in 23 patients (14 boys and nine girls) aged 1 month to 6.5 years, and the anteroposterior diameter, width, area, and perimeter of the trachea were determined. Seven of the 23 patients had undergone FETO and 16 had been treated expectantly. The relative difference of each parameter between the two most proximal concentric sections of the trachea, just below the larynx, and the two sections on which the trachea was the largest was compared between both groups (Mann-Whitney U test). Regression statistics were applied to maximum and mean tracheal areas as a function of age. Each trachea was divided into quartiles, and mean areas normalized to 3 years of age were analyzed for each quartile as a function of its relative position on the trachea (Student t test).
Tracheal width, area, and perimeter were significantly different between both groups. A linear relationship was observed between the maximum and mean tracheal areas and age for both the FETO group (maximum tracheal area: R(2) = 0.83, P = .0045; mean tracheal area: R(2) = 0.92, P = .0005) and the non-FETO group (maximum tracheal area: R(2) = 0.66, P = .0001; mean trachea area: R(2) = 0.66, P = .0001). The maximum tracheal area in both groups tended to decrease toward the age of 5 years. Significantly different mean tracheal areas per tracheal quartile (P < .05) were found for all quartiles except for the proximal one-fourth.
The relative difference between proximal and largest tracheal width, area, and perimeter was significantly larger in patients who underwent FETO than in those treated expectantly, demonstrating tracheal dilatation in the former. Measurements of tracheal dimensions at different levels indicate a maximum dilatation in the lower half of the trachea, which tends to level off toward the age of 5 years.
测量接受胎儿镜腔内气管阻塞术（FETO）或宫内期待治疗的先天性膈疝（CDH）患儿的气管尺寸。
该研究经当地伦理委员会批准。对 23 名 1 个月至 6.5 岁的患儿进行了计算机断层扫描，测量了气管的前后直径、宽度、面积和周长。23 名患儿中，7 例行 FETO，16 例行期待治疗。比较两组中最接近声门下的气管两个最近端同心段和气管最大段之间的每个参数的相对差异（Mann-Whitney U 检验）。将最大和平均气管面积作为年龄的函数进行回归统计。将每个气管分为四等份，根据其在气管上的相对位置，分析每个四分位数的 3 岁时的平均面积与年龄的关系（学生 t 检验）。
两组间气管的宽度、面积和周长差异有统计学意义。FETO 组和非 FETO 组的最大和平均气管面积均与年龄呈线性关系（最大气管面积：R²=0.83，P=0.0045；平均气管面积：R²=0.92，P=0.0005）。两组最大气管面积均有向 5 岁年龄减小的趋势。除近端四分之一段外，所有四分位数的平均气管面积差异均有统计学意义（P＜0.05）。
接受 FETO 的患儿近端和最大气管的宽度、面积和周长的相对差异明显大于期待治疗的患儿，表明前者气管扩张。不同水平的气管尺寸测量表明，气管下半部扩张最大，5 岁左右趋于稳定。
