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The relationship between three signs of fetal magnetic resonance imaging and severity of congenital diaphragmatic hernia

Journal of Perinatology volume 37, pages 265–269 (2017)Cite this article

Subjects

Abstract

Objective:

To seek a simple approach for prenatally classifying congenital diaphragmatic hernia (CDH) severity using fetal magnetic resonance imaging (MRI) markers.

Study design:

A retrospective, multicenter study using questionnaires to investigate fetal MRI findings. We included fetuses prenatally diagnosed with isolated left-sided CDH and delivered after 36 weeks of gestation. We focused on three fetal MRI morphological signs: incomplete pulmonary baseline (IPB), liver up (LU) and retrocardiac stomach (RCS). We also evaluated the fetal MRI score defined as the total number of positive signs; the primary outcome was survival at discharge.

Results:

In 256 patients (from 56 institutions), IPB, LU and RCS findings correlated with lower survival: odds ratio (95% confidence interval), 0.16 (0.08 to 0.33); 0.24 (0.12 to 0.51); and 0.14 (0.07 to 0.28); respectively. Patients with higher fetal MRI scores had a higher mortality rate.

Conclusion:

IPB, LU and RCS on fetal MRI are related to CDH severity.

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Acknowledgements

We thank the persons in charge of the participating institutions for responding to our research.

Author information

Authors and Affiliations

  1. Division of Neonatology, Center for Maternal-Neonatal Care, Nagoya University Hospital, Nagoya, Japan

    T Hattori, M Hayakawa, M Ito & Y Sato

  2. Department of Pediatrics, Anjo Kosei Hospital, Anjo, Japan

    T Hattori

  3. Department of Nursing, Nagoya University Graduate School of Medicine, Nagoya, Japan

    K Tamakoshi

  4. Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Tokyo, Japan

    Y Kanamori

  5. Department of Pediatric Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan

    H Okuyama

  6. Department of Pediatrics Kindai University, Faculty of Medicine, Osaka-sayama, Osaka, Japan

    N Inamura

  7. Division of Neonatology, Center of Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan

    S Takahashi

  8. Department of Anesthesiology and Intensive Care, Osaka University Graduate School of Medicine, Suita, Osaka, Japan

    Y Fujino

  9. Department of Pediatric Surgery, Reproductive and Developmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

    T Taguchi

  10. Department of Pediatric Surgery, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Osaka, Japan

    N Usui

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  1. T Hattori
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  2. M Hayakawa
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  7. H Okuyama
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  10. Y Fujino
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  11. T Taguchi
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  12. N Usui
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Corresponding author

Correspondence to T Hattori.

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Competing interests

Tetsuo Hattori wrote the first draft of the manuscript. The remaining authors declare no conflict of interest.

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Hattori, T., Hayakawa, M., Ito, M. et al. The relationship between three signs of fetal magnetic resonance imaging and severity of congenital diaphragmatic hernia. J Perinatol 37, 265–269 (2017). https://doi.org/10.1038/jp.2016.208

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  • DOI: https://doi.org/10.1038/jp.2016.208

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