Predicting outcomes of congenital diaphragmatic hernia by calculating liver herniation derives

Abstract

Objective - to assess relationship between degree of liver herniation and mortality rate in postnatal period.

Material and methods. Prospective study included 71 pregnant women at 18 weeks gestational age with congenital diaphragmatic hernia according to ultrasound data. All woman underwent MRI with calculation percent of liver herniation and liver to thorax ratio. Liver and thorax volume was measured on T2WI by manually tracing region of interest and summing selected areas. All structures of thoracic cavity (except spine) were included. Percent liver herniation was defined as ratio of liver displacement volume (volume of liver located inside the chest) to the total liver volume.

Results. Among survivors significantly lower degree of liver herniation and liver to thorax ratio were observed - 7.54 (0-9.84) and 4.76 (0-5.97) respectively (p<0.001). Corresponding indicators for deceased were 20.07 (3.99-31.85) and 14.91 (2.28-22.94). Area under the curve for liver to thorax ratio was 0.766, for liver herniation - 0.767. Among survivors weak positive correlation was found between degree of liver herniation and liver to thorax volume with rate of using biodegradable material for plastic diaphragm defect (r=0.345, p=0.038 and r=0.389, p=0.018, respectively). Among deceased weak negative correlation with number of days at the time of death was revealed (r=0.357, p=0.035 and r=0.349, p=0.039, respectively).

Conclusion. Data obtained allow to use liver herniation derives as predictors of poor prognosis in cases of congenital diaphragmatic hernia.

Keywords:fetal MRI, congenital diaphragmatic hernia, fetal liver herniation, prenatal imaging, liver to thorax ratio

Funding. The study had no sponsor support.

Conflict of interests. The authors declare no conflict of interests.

For citation: Syrkashev E.M., Solopova A.E., Bychenko V.G., Burov A.A., Podurovskaya Yu.L., Gus A.I. Predicting outcomes of congenital diaphragmatic hernia by calculating liver herniation derives. Neonatologiya: novosti, mneniya, obuchenie [Neonatology: News, Opinions, Training]. 2021; 9 (1): 24-9. DOI: https://doi.org/10.33029/2308-2402-2021-9-1-24-29 (in Russian)

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CHIEF EDITOR
CHIEF EDITOR
Degtyarev Dmitriy Nikolaevich
Doctor of Medical Sciences, Professor, Deputy Director for Scientific Research of the V.I. Kulakov Obstetrics, Gynecology and Perinatology National Medical Research Center of Ministry of Healthсаre of the Russian Federation, Head of the Chair of Neonatology at the Clinical Institute of Children's Health named after N.F. Filatov, I.M. Sechenov First Moscow State Medical University, Chairman of the Ethics Committee of the Russian Society of Neonatologists, Moscow, Russian Federation

ORCID iD 0000-0001-8975-2425
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