Fetal MRI mediastinal shift angle and respiratory and cardiovascular pharmacological support in newborns with congenital diaphragmatic hernia

2021 ◽  
Author(s):  
Ilaria Amodeo ◽  
Irene Borzani ◽  
Giulia Corsani ◽  
Nicola Pesenti ◽  
Genny Raffaeli ◽  
...  
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Fetal Mri ◽  
Mediastinal Shift ◽  
Shift Angle

scholarly journals Fetal MRI Mediastinal Shift Angle, Respiratory and Cardiovascular Pharmacological Support in Newborns With Congenital Diaphragmatic Hernia

2021 ◽  
Author(s):  
Ilaria Amodeo ◽  
Irene Borzani ◽  
Giulia Corsani ◽  
Nicola Pesenti ◽  
Genny Raffaeli ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Linear Models ◽  
Fetal Mri ◽  
Inverse Correlation ◽  
Lung Hypoplasia ◽  
Clinical Trial Registration ◽  
Mediastinal Shift ◽  
Shift Angle

Abstract Introduction. In newborns with congenital diaphragmatic hernia (CDH), the mediastinal shift caused by the herniated organs negatively affects lung development. Assessment of the fetal magnetic resonance imaging (MRI) mediastinal shift angle (MSA) was shown to have an inverse correlation with the total fetal lung volume (TFLV), being associated with neonatal survival. However, a possible association with postnatal morbidity has never been investigated. We hypothesize that the degree of the mediastinal shift could be associated with higher respiratory and cardiocirculatory impairment, requiring intensive treatments and extended hospitalization in survivors.Method. We retrospectively consider a cohort of isolated, left-sided CDH, for whom we calculated the MSA and the observed/expected (O/E) TFLV at fetal MRI. We performed a data collection regarding inotropic or vasoactive support, treatment with pulmonary vasodilators, mechanical ventilation, and length of stay. General linear models were performed. Results. The MSA and O/E TFLV were inversely correlated (Pearson’s coefficient -0.65, p < 0.001) and deceased patients showed higher MSA values then survivors (p = 0.011). Among survivors, an increase in MSA was associated with longer pharmacological treatments (dobutamine: p = 0.016; dopamine: p = 0.049; hydrocortisone: p = 0.003; nitric oxide: p = 0.002; sildenafil: p = 0.039; milrinone: p = 0.039; oxygen: p = 0.066), and mechanical ventilation (p = 0.005), with an increasing trend in the length of hospitalization (p = 0.089). Conclusions. The MSA indirectly reflects lung hypoplasia and is associated with the higher neonatal intensity of cares. Further studies are needed to consolidate the results. Clinical Trial Registration: The study is an exploratory post-hoc analysis of the registered NeoAPACHE protocol at ClinicalTrials.gov with the identifier NCT04396028

Fetal MRI assessment of mediastinal shift angle in isolated left congenital diaphragmatic hernia: A new postnatal survival predictive tool?

2019 ◽  
Vol 40 (1) ◽  
pp. 136-141 ◽  
Author(s):  
Sara Savelli ◽  
Stefano Bascetta ◽  
Chiara Carducci ◽  
Enza Carnevale ◽  
Leonardo Caforio ◽  
...  
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Fetal Mri ◽  
Predictive Tool ◽  
Mediastinal Shift ◽  
Shift Angle

413: Meta-analysis of predictors for survival in isolated congenital diaphragmatic hernia using fetal MRI

2009 ◽  
Vol 201 (6) ◽  
pp. S159
Author(s):  
Steffi Mayer ◽  
Scott Petersen ◽  
Philipp Klaritsch ◽  
Elisa Done' ◽  
Steffen Fieuws ◽  
...  
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Meta Analysis ◽  
Fetal Mri

scholarly journals Three‐dimensional reconstruction of defects in congenital diaphragmatic hernia: a fetal MRI study

2019 ◽  
Vol 53 (6) ◽  
pp. 816-826 ◽  
Author(s):  
F. Prayer ◽  
M. Metzelder ◽  
W. Krois ◽  
P. C. Brugger ◽  
G. M. Gruber ◽  
...  
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Three Dimensional ◽  
Fetal Mri ◽  
Three Dimensional Reconstruction ◽  
Dimensional Reconstruction ◽  
Mri Study

scholarly journals OC31.02: Evaluation of cortical development by fetal MRI in fetuses with congenital diaphragmatic hernia between 26–29 weeks of gestation

2019 ◽  
Vol 54 (S1) ◽  
pp. 81-82
Author(s):  
M. Aertsen ◽  
N.M. Hahner ◽  
L. De Catte ◽  
E. Eixarch ◽  
O. Gómez ◽  
...  
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Cortical Development ◽  
Fetal Mri

scholarly journals Motion corrected fetal body MRI provides reliable 3D lung volumes in normal and abnormal fetuses

2021 ◽  
Author(s):  
Joseph Davidson ◽  
Alena Uus ◽  
Alexia Egloff Collado ◽  
Milou Van Poppel ◽  
Jacqueline Matthew ◽  
...  
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Lung Volume ◽  
Fetal Mri ◽  
Fetal Lung ◽  
Lung Hypoplasia ◽  
Healthy Controls ◽  
Lung Volumes ◽  
Total Lung Volume ◽  
Volume Registration

Abstract Objective:Evaluate deformable slice-to-volume registration (DSVR) to calculate 3D-segmented total lung volume (TLV) in fetuses with congenital diaphragmatic hernia, congenital lung lesions and healthy controls, with comparison to 2D-manual segmentation. Design:Pilot study Setting:Regional fetal medicine referral centre Sample:Fetal MRIs performed for clinical indications (abnormal cases) or as research participants (healthy controls) Methods:Sixteen MRI datasets of fetuses (22-32 weeks GA). Diagnosis: CDH(n=5), CPAM(n=2), CDH with BPS(n=1) and healthy control(n=8). DSVR was used for reconstruction of 3D isotropic (0.85 mm) volumes of fetal body followed by semi-automated lung segmentation. The resulting 3D TLV were compared to the traditional 2D-based volumetry, and a normogram of DSVR-derived fetal lung volumes from 100 cases was produced. Main Outcome Measures:Concordance with 2D-volumetry assessed with Bland-Altman analysis, results of segmentations presented visually. Observed/Expected values were calculated for abnormal cases based upon the normogram. Results:DSVR-derived TLV values have high correlation with the 2D-based measurements but with a consistently lower volume; bias -1.44cm3 [95% limits: -2.6 to -0.3] with improved resolution able to exclude hilar structures even in severe motion corruption or in cases of lung hypoplasia. Conclusions:Application of DSVR for fetal MRI provides a solution for analysis of motion corrupted scans and does not suffer from the interpolation error inherent in 2D-segmentation as per current clinical practice. It increases information content of acquired data in terms of visualising organs in 3D space and quantification of volumes, which we believe will have important value for counselling and surgical planning. Keywords:Fetal MRI; congenital diaphragmatic hernia; CPAM; lung volume

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