左侧先天性膈疝中胃位置与肝-胸容积比的关系
Stomach position versus liver-to-thoracic volume ratio in left-sided congenital diaphragmatic hernia.
作者信息
Cordier Anne-Gaël, Cannie Mieke M, Guilbaud Lucie, De Laveaucoupet Jocelyne, Martinovic Jéléna, Nowakowska Dorota, Milejska-Lewandowska Malgorzata, Rodó Carlota, Viaris de Lesegno Benjamin, Votino Carmela, Senat Marie-Victoire, Jani Jacques C, Benachi Alexandra
机构信息
Department of Obstetrics, Gynecology and Reproductive Medicine, Centre Maladies Rares, Hernie de Coupole Diaphragmatique, Hôpital Antoine Béclère, APHP, Université Paris Sud , Paris , France .
出版信息
J Matern Fetal Neonatal Med. 2015 Jan;28(2):190-5. doi: 10.3109/14767058.2014.906576. Epub 2014 Apr 25.
OBJECTIVE
To describe a new grading method for stomach position (SP) in fetuses with left-sided congenital diaphragmatic hernia (L-CDH) using ultrasound and to correlate SP to liver position and to liver-to-thoracic cavity volume ratio (LiTR) using magnetic resonance imaging.
METHODS
SP were graded at the level of the 4-chamber view as following: grade 1-to-4 for stomach not visualised, visualised anteriorly at the apex of the heart, stomach showing abdominal structures anteriorly and stomach with its larger part posterior to the level of the atrial-ventricular heart valves, respectively. The LiTR was calculated and correlated to SP using the Mann-Whitney U test.
RESULTS
Seventy-four fetuses were included. Median LiTR for grade 1 SP was 0% and was not different from median LiTR for grade 2 SP (0%, p=NS). Median LiTR for grade 3 SP was 14.9% and was significantly higher than for grade 2 SP (p<0.001). Similarly, median LiTR for grade 4 SP was 20.7% and was significantly higher than for grade 3 SP (p<0.05). When SP was grade 1 or 2, liver was intra-abdominal in 21 (84%) out of 25 fetuses while it was always intrathoracic for SP 3 or 4.
CONCLUSION
In L-CDH, SP as described represents a simple indirect measurement of intrathoracic position and quantification of liver.
目的
描述一种利用超声对左侧先天性膈疝（L - CDH）胎儿的胃位置（SP）进行新的分级方法，并通过磁共振成像将SP与肝脏位置以及肝脏与胸腔容积比（LiTR）进行关联。
方法
在四腔心切面水平对SP进行分级如下：胃未显示为1级，在心脏尖部前方显示为2级；胃前方显示腹部结构为3级；胃大部分位于房室心脏瓣膜水平后方为4级。计算LiTR，并使用曼 - 惠特尼U检验将其与SP进行关联。
结果
纳入74例胎儿。1级SP的LiTR中位数为0%，与2级SP的LiTR中位数（0%，p = 无统计学差异）无差异。3级SP的LiTR中位数为14.9%，显著高于2级SP（p < 0.001）。同样，4级SP的LiTR中位数为20.7%，显著高于3级SP（p < 0.05）。当SP为1级或2级时，25例胎儿中有21例（84%）肝脏位于腹腔内，而当SP为3级或4级时，肝脏总是位于胸腔内。
结论
在L - CDH中，所描述的SP是胸腔内位置和肝脏定量的一种简单间接测量方法。
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