Three‐dimensional sonographic measurement of contralateral lung volume in fetuses with isolated congenital diaphragmatic hernia

Abstract

Although o/e-ContFLVR can be precisely measured with 3DUS and can be used to predict neonatal death in CDH, it is less accurate than LHR and o/e-TotFLVR for that purpose.

Ipsilateral Lung Volumes Assessed by Three-Dimensional Ultrasonography in Fetuses with Isolated Congenital Diaphragmatic Hernia

“…In the present study, the o/eIpsiFLVR was also calculated in order to avoid influence of gestational age. Comparing the results described in the present study with our previous studies [21,24] , it is possible to demonstrate that the ipsilateral lung volumes (mean = 0.15 cm 3 ; range = 0.01-0.66 cm 3 ) are more reduced than the contralateral lung volumes (median = 0.51 cm 3 ; range = 0.11-0.95 cm 3 ). This confirms the hypothesis that both lungs are impaired in isolated CDH, but the ipsilateral lungs are more hypoplastic than the contralateral ones.…”

“…However, the importance of measuring the ipsilateral lung volumes may be for calculating the total fetal lung volumes. As reported before [24] , the o/e-TotFLVR is the most efficient parameter for the prediction of neonatal deaths in isolated CDH (accuracy of 80.7%) when compared to the LHR (accuracy of 77.4%), the o/e-ContFLVR (accuracy of 67.7%) and now to the o/e-IpsiFLVR (accuracy of 64.%). Further studies with more cases are necessary to confirm these results and the importance of measuring the contralateral and ipsilateral lung volumes in isolated CDH.…”

“…Total and contralateral fetal lung volumes can be measured precisely on 3DUS [23,24] correlating significantly with neonatal deaths [21,24] . Total fetal lung can be calculated using the rotational technique (VOCAL TM ) by summing the right and left lung volumes [19][20][21][22][23] .…”

“…Initial results showed that an observed/expected total fetal lung volume ratio (o/e-TotFLVR) lower than 0.35 was significantly associated with neonatal deaths [21] , confirming the results of previous studies using MRI [15][16][17][18] . Observed/expected contralateral lung volume ratios (o/eContFLVR) can also be used to predict neonatal death, but with lower accuracy than o/e-TotFLVR and lung/ head ratio (LHR) [24] . Measuring the volumes of the ipsilateral lungs to the diaphragmatic defect may be more difficult than measuring the contralateral lung volumes [24,25] .…”

“…Observed/expected contralateral lung volume ratios (o/eContFLVR) can also be used to predict neonatal death, but with lower accuracy than o/e-TotFLVR and lung/ head ratio (LHR) [24] . Measuring the volumes of the ipsilateral lungs to the diaphragmatic defect may be more difficult than measuring the contralateral lung volumes [24,25] . However, the potential of the ipsilateral lung volumes to predict neonatal death in CDH remains to be studied.…”