Link: http://www.ncbi.nlm.nih.gov/pubmed/26135752

Prenat Diagn. 2015 Jul 1. doi: 10.1002/pd.4642. [Epub ahead of print]
In Vivo Evidence by Magnetic Resonance Volumetry of a Gestational Age Dependent Response to Tracheal Occlusion for Congenital Diaphragmatic Hernia.
Nawapun K1,2, Eastwood MP1, Diaz-Cobos D3, Jimenez J1,4, Aertsen M5, Gomez O3, Claus F5,6, Gratacos E3, Deprest J1,7.
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Abstract
OBJECTIVE:
To assess in vivo changes in lung and liver volume in fetuses with isolated congenital diaphragmatic hernia (CDH), either expectantly managed or treated in utero.

METHOD:
This is a secondary analysis of prospectively collected data at 2 fetal therapy centers. We used archived magnetic resonance (MR) images of fetuses taken ≥7 days apart, creating paired observations in 20 expectantly managed cases, 41 with a second MR prior to balloon reversal and 64 after balloon removal. We measured observed to expected total fetal lung volume (O/E TFLV) and liver-to-thoracic volume ratio (LiTR). We calculated changes in volume as compared to the initial measurement and its rate as a function of gestational age (GA) at occlusion.

RESULTS:
The LiTR did not change in either group. In expectantly managed fetuses, O/E TFLV did not increase with gestation. In fetuses undergoing tracheal occlusion (TO) the measured increase in volume was 2.6-times larger with balloon in place as compared to after its removal. GA at TO was an independent predictor of the O/E TFLV. The net rate seems to initially increase and plateau at a maximum of 1.5%/week by 35-45 days after occlusion.

CONCLUSIONS:
TO induces a net increase in volume, its magnitude essentially dependent on the GA at occlusion. This article is protected by copyright. All rights reserved.

This article is protected by copyright. All rights reserved.

PMID: 26135752 [PubMed - as supplied by publisher]