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  • Title: The relationship between three signs of fetal magnetic resonance imaging and severity of congenital diaphragmatic hernia.
    Author: Hattori T, Hayakawa M, Ito M, Sato Y, Tamakoshi K, Kanamori Y, Okuyama H, Inamura N, Takahashi S, Fujino Y, Taguchi T, Usui N.
    Journal: J Perinatol; 2017 Mar; 37(3):265-269. PubMed ID: 27977015.
    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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