Abstract:
This is a retrospective study investigating the relationship between ultrasound and magnetic resonance imaging (MRI) examinations in congenital diaphragmatic hernia (CDH). CDH is a rare cause of pulmonary hypoplasia that increases the mortality and morbidity of patients. Inclusion criteria were: patients diagnosed with CDH who underwent MRI examination after the second-trimester morphology ultrasound confirmed the presence of CDH. The patients came from three university hospitals in Bucharest, Romania. A total of 22 patients were included in the study after applying the exclusion criteria. By analyzing the total lung volume (TLV) using MRI, and the lung to head ratio (LHR) calculated using MRI and ultrasound, we observed that LHR can severely underestimate the severity of the pulmonary hypoplasia, even showing values close to normal in some cases. This also proves to be statistically relevant if we eliminate certain extreme values. We found significant correlations between the LHR percentage and herniated organs, such as the left and right liver lobes and gallbladder. MRI also provided additional insights, indicating the presence of pericarditis or pleurisy. We wish to underline the necessity of MRI follow-up in all cases of CDH, as the accurate measurement of the TLV is important for future treatment and therapeutic strategy.
摘要:
这是一项回顾性研究,研究先天性膈疝(CDH)的超声和磁共振成像(MRI)检查之间的关系。CDH是肺发育不全的罕见原因,会增加患者的死亡率和发病率。纳入标准为:诊断为CDH的患者,在孕中期形态学超声检查后接受MRI检查,证实存在CDH。病人来自布加勒斯特的三家大学医院,罗马尼亚。在应用排除标准后,共有22名患者被纳入研究。通过MRI分析肺总容积(TLV),使用MRI和超声计算肺头比(LHR),我们观察到LHR可以严重低估肺发育不全的严重程度,甚至在某些情况下显示接近正常值。如果我们消除某些极端值,这也被证明是统计上相关的。我们发现LHR百分比和突出器官之间存在显著相关性,如左右肝叶和胆囊。MRI还提供了额外的见解,提示存在心包炎或胸膜炎。我们希望强调在所有CDH病例中进行MRI随访的必要性,因为TLV的精确测量对未来的治疗和治疗策略很重要。