METHODS: In a total of 122 fetal MRIs, the MSA and pALV were measured retrospectively and complete outcome parameters were determined regarding survival for all 122 subjects, regarding ECMO therapy in 109 cases and about the development of CLD in 78 cases. The prognostic value regarding the endpoints was evaluated using logistic regression and ROC analysis.
RESULTS: The MSA was significantly higher in children who received ECMO therapy (p = 0.0054), as well as in children who developed CLD (p = 0.0018). ROC analysis showed an AUC of 0.68 for ECMO requirement and 0.77 with respect to CLD development. The pALV showed a tendency towards higher levels in children who received ECMO therapy (p = 0.0824). The MSA and the pALV had no significant effect on survival (MSA: p = 0.4293, AUC = 0.56; pALV: p = 0.1134, AUC = 0.57).
CONCLUSIONS: The MSA determined in fetal MRI is a suitable prognostic parameter for ECMO requirement and CLD development in CDH patients and can possibly be used as a supplement to the established parameters.
方法:在总共122例胎儿MRI中,对所有122例受试者进行了MSA和pALV回顾性测量,并确定了关于生存的完整结局参数,关于ECMO治疗109例和CLD发展78例。使用逻辑回归和ROC分析评估关于终点的预后价值。
结果:接受ECMO治疗的儿童的MSA明显更高(p=0.0054),以及患有CLD的儿童(p=0.0018)。ROC分析显示ECMO需求的AUC为0.68,CLD发展的AUC为0.77。在接受ECMO治疗的儿童中,pALV显示出更高水平的趋势(p=0.0824)。MSA和pALV对存活没有显著影响(MSA:p=0.4293,AUC=0.56;pALV:p=0.1134,AUC=0.57)。
结论:在胎儿MRI中确定的MSA是CDH患者ECMO需求和CLD发展的合适预后参数,并且可能用作已建立参数的补充。