Lisa Suzuki MD, Presenter: Nothing to Disclose

Anne Marie Hubbard MD, Abstract Co-Author: Nothing to Disclose

Enrico Danzer, Abstract Co-Author: Nothing to Disclose

Scott Adzick, Abstract Co-Author: Nothing to Disclose

To determine if lung volume (LV) or chest diameters obtained from prenatal magnetic resonance (MR) images is predictive of outcome in fetus with omphalocele.

Fetal MR of 32 patients (19-32 wk) with omphalocele performed at single institution were reviewed retrospectively. Twelve patients were excluded because follow up was not available. Following measurements were obtained in the HASTE images: LV, AP= axial anteroposterior at diaphragm, WA= axial width at diaphragm, WC1= coronal width at carina and WC2= coronal width at diaphragm. Omphaloce was classified as giant (containing liver) or small (without liver). Results were correlated with gestational age (GA), severity of omphalocele and outcome. The same measurements were performed in 27 fetuses (19-33 wk) without thoracoabdominal anomalies as a control group.

Nine of 20 patients are alive without pulmonary complication. Six are alive with chronic lung disease. Four patients died after birth because of pulmonary hypoplasia. One patient was stillborn and had pulmonary hypoplasia. The total LV ranged from 6.7 – 45 ml in omphalocele patients and from 10.7 – 98 ml in control group. Linear increasing in LV was observed with increasing GA in both groups. Chest diameters were 2.2 – 5.4 cm (WA), 1.5 - 4.5 cm (AP), 2.4 – 4.9 cm (WC1) and 2.7 – 5.5 cm (WC2) in omphalocele patients. In the control group, chest diameters were 3 – 7 cm (WA), 2- 5.3 cm (AP), 2.5- 6.4 cm (WC1) and 3.2 – 8 cm (WC2). LV and chest diameters were smaller in patients with giant omphalocele when compared to patients with small omphalocele or control group. Patients with small omphalocele have LV and chest diameters comparable to the control group. Statistical analysis showed that LV proved to be the strongest outcome predictor, followed by coronal width at carina.

Patients with smaller lung volume and chest diameters for the GA have higher mortality and morbidity in omphalocele patients. Coronal width at carina seen to be promising in predicting outcome in omphalocele patients.

Suzuki, L, Hubbard, A, Danzer, E, Adzick, S, Fetal Lung Volume and Chest Diameters Assessed by MR in Omphalocele Patients: Prognostic Value.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4412598.html