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Expanded intrathoracic space in fetal cases of isolated congenital diaphragmatic hernia contributes to disparity between percent predicted lung volume and observed to expected total lung volume.
[congenital diaphragmatic hernia]
The
aim
of
this
study
was
to
determine
whether
fetal
lung
volume
and
visceral
herniation
are
associated
with
changes
in
intrathoracic
space
in
congenital
diaphragmatic
hernia
(
CDH
)
.
We
retrospectively
examined
the
relationship
between
magnetic
resonance
imaging-derived
measurements
of
intrathoracic
space
[
predicted
lung
volume
(
PLV
)
]
and
residual
lung
volume
or
visceral
herniation
among
isolated
left-sided
CDH
fetuses
.
Data
from
fetal
magnetic
resonance
imaging
studies
of
60
isolated
left-sided
CDH
cases
were
analyzed
.
The
median
PLV
of
the
CDH
fetuses
was
found
to
be
much
greater
than
the
expected
total
lung
volume
(
eTLV
)
of
a
normal
fetus
at
the
same
gestational
age
.
Surprisingly
,
liver
herniation
and
observed
TLV
(
oTLV
)
were
positively
correlated
with
the
PLV
.
Although
the
PPLV
was
consistently
less
than
the
o
/
eTLV
,
both
indices
were
greater
in
survivors
than
in
non-survivors
,
whereas
no
significant
difference
was
seen
in
the
PLV
/
eTLV
ratio
in
regard
to
survivorship
.
The
intrathoracic
domain
available
for
lungs
and
viscera
is
expanded
in
CDH
fetuses
and
positively
affected
by
the
lung
volume
and
the
presence
of
liver
herniation
,
leading
to
the
difference
in
the
PPLV
and
o
/
eTLV
.
Future
study
of
intrathoracic
space
as
it
relates
to
the
growth
of
the
lung
and
herniated
viscera
is
needed
to
better
characterize
the
relationship
between
these
parameters
.
©
2014
John
Wiley
&
Sons
,
Ltd
.