基于图像的产前预测指标在右膈疝患儿出生后存活率、体外生命支持和缺陷大小方面的应用。
Image-based prenatal predictors of postnatal survival, extracorporeal life support, and defect size in right congenital diaphragmatic hernia.
机构信息
Division of Neonatal and Developmental Medicine, Stanford University School of Medicine, Palo Alto, CA, 94305, USA.
Department of Primary Care and Population Health, Stanford University School of Medicine, Palo Alto, CA, 94304, USA.
出版信息
J Perinatol. 2022 Sep;42(9):1202-1209. doi: 10.1038/s41372-022-01470-x. Epub 2022 Aug 3.
OBJECTIVE
To determine the association between prenatal ultrasound (US) and magnetic resonance imaging (MRI) characteristics in right congenital diaphragmatic hernia (RCDH) with postnatal outcome.
STUDY DESIGN
CDH Study Group data were reviewed for all RCDH infants (n = 156) born between 2015 and 2019. Prenatal US and MRI lung size measurements were correlated with survival, extracorporeal life support (ECLS), and defect size.
RESULT
Overall survival was 64.1%. ECLS was required in 40.4%. US and MRI-based prenatal assessment of pulmonary hypoplasia does not predict survival. Prenatal measurement of lung size using either US or MRI correlates with ECLS use. Only MRI-based measures of lung size are associated with defect size.
CONCLUSION
Image-based prenatal predictors of survival, ECLS, and defect size are of limited value in RCDH. Extrapolation of prenatal survival and morbidity indicators from left to right-sided CDH is not appropriate. There is an urgent need to develop RCDH prenatal prediction models.
目的
确定右先天性膈疝（RCDH）中产前超声（US）和磁共振成像（MRI）特征与产后结局的关系。
研究设计
对 2015 年至 2019 年间出生的所有 RCDH 婴儿（n=156）的 CDH 研究组数据进行了回顾。对生存、体外生命支持（ECLS）和缺陷大小与产前 US 和 MRI 肺大小测量值进行相关性分析。
结果
总体生存率为 64.1%。40.4%需要 ECLS。产前肺发育不全的 US 和 MRI 评估均不能预测生存率。使用 US 或 MRI 进行产前肺大小测量与 ECLS 的使用相关。只有基于 MRI 的肺大小测量值与缺陷大小相关。
结论
RCDH 中，基于图像的生存、ECLS 和缺陷大小的产前预测指标价值有限。将左到右侧 CDH 的产前生存和发病率指标推断到 RCDH 是不合适的。迫切需要开发 RCDH 产前预测模型。
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