Akihiro Nishie MD, Presenter: Nothing to Disclose

Kengo Yoshimitsu MD, Abstract Co-Author: Nothing to Disclose

Tomohiro Nakayama MD, Abstract Co-Author: Nothing to Disclose

Tsuyoshi Tajima MD, PhD, Abstract Co-Author: Nothing to Disclose

Kousei Ishigami MD, Abstract Co-Author: Nothing to Disclose

Hiroshi Honda MD, Abstract Co-Author: Nothing to Disclose

Masakazu Hirakawa MD, Abstract Co-Author: Nothing to Disclose

Yasuhiro Ushijima MD, Abstract Co-Author: Nothing to Disclose

Daisuke Kakihara MD, Abstract Co-Author: Nothing to Disclose

Daisuke Okamoto MD, Abstract Co-Author: Nothing to Disclose

Takashi Yoshiura MD, PhD, Abstract Co-Author: Nothing to Disclose

Kouji Masumoto, Abstract Co-Author: Nothing to Disclose

Tomoaki Taguchi, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

To investigate the validity of the fetal right lung-to-liver signal intensity ratio (LLSIR) for prediction of postnatal outcomes in left-sided congenital diaphragmatic hernia (CDH) and compare it with that of right fetal lung volume (FLV).

The study included 14 pregnant women who underwent MR exams for evaluation of fetal left-sided CDH. The fetuses were divided into two groups depending upon the postnatal outcome; Group A (n=9), alive at least for 20 months, and Group B (n=5), dead within 55 days after birth. On the basis of the half-Fourier acquisition single-shot turbo spin-echo sequence, LLSIR was calculated by placing regions of interest, and the right FLV was measured by multiplying lung area on each image by a total of the slice thickness and the intersection gap. In the control group (n=21), a regression analysis was performed to associate LLSIR and right FLV with gestational age, and each standard formula was yielded. The relative LLSIR and right FLV (the observed/expected LLSIR and right FLV) were compared between Groups A and B.

The mean relative LLSIR, as well as the mean relative right FLV, of Group A was significantly higher than that of Group B (p=0.035). Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for the relative LLSIR and the relative right FLV, when the cut-off point was defined as 0.646 and 0.420, were the same and were 88.9%, 80.0%, 88.9%, 80.0%, and 85.7%, respectively.

The postnatal outcomes in left-sided CDH may be predicted using the LLSIR. Its performance is comparable to that of the right FLV.

We can predict postnatal outcomes in CDH easily by measuring the SI of the contralateral lung to the herniated side on T2-weighted MR imaging.

Nishie, A, Yoshimitsu, K, Nakayama, T, Tajima, T, Ishigami, K, Honda, H, Hirakawa, M, Ushijima, Y, Kakihara, D, Okamoto, D, Yoshiura, T, Masumoto, K, Taguchi, T, et al, , MR Prediction of Postnatal Outcomes in Left-sided Congenital Diaphragmatic Hernia Using Right Lung Signal Intensity.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6014158.html