Evidence map›Paper›PMID 37644150›Full record

ArticleEuropean radiology2024

Prenatal MRI assessment of mediastinal shift angle as a feasible and effective risk stratification tool in isolated right-sided congenital diaphragmatic hernia.

Wen Ding, Yuanyuan Gu, Haiyu Wang, Huiying Wu, Xiaochun Zhang, Rui Zhang, Hongying Wang, Li Huang, Junjian Lv, Bo Xia and 3 more

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In one paragraph

Article in European radiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

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2citing papers in PubMed, 1 pooled it
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1 · What the graph read from it

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

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3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

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5 · Who and what money

Authors and funding

13 authors.

Wen DingDepartment of Fetal Medicine, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
Yuanyuan GuDepartment of Fetal Medicine, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China. physiciansci_gu@outlook.com.ORCID http://orcid.org/0000-0003-0289-280X
Haiyu WangDepartment of Medical Imaging, Guangzhou Women and Children's Medical Center, Guangzhou, China.
Huiying WuDepartment of Medical Imaging, Guangzhou Women and Children's Medical Center, Guangzhou, China.
Xiaochun ZhangDepartment of Medical Imaging, Guangzhou Women and Children's Medical Center, Guangzhou, China.
Rui ZhangDepartment of Medical Imaging, Guangzhou Women and Children's Medical Center, Guangzhou, China.
Hongying WangDepartment of Medical Imaging, Guangzhou Women and Children's Medical Center, Guangzhou, China.
Li HuangDepartment of Medical Imaging, Guangzhou Women and Children's Medical Center, Guangzhou, China.
Junjian LvSurgical Neonatal Intensive Care Unit, Guangzhou Women and Children's Medical Center, Guangzhou, China.
Bo XiaSurgical Neonatal Intensive Care Unit, Guangzhou Women and Children's Medical Center, Guangzhou, China.
Wei ZhongDepartment of Pediatric Surgery, Guangzhou Women and Children's Medical Center, Guangzhou, China.
Qiuming HeDepartment of Pediatric Surgery, Guangzhou Women and Children's Medical Center, Guangzhou, China.
Longlong HouDepartment of Pediatric Surgery, Guangzhou Women and Children's Medical Center, Guangzhou, China.

Funding

Guangzhou Institute of Pediatrics, Guangzhou Women and Childrens Medical Center No.4001027Major Project of Department of Science and Technology of Guangdong Province No.2019B020227001Major Project of Department of Science and Technology of Guangdong Province No.2019B030301004Science and Technology Program of Guangzhou No.202102010016
6 · The paper itself

Abstract

objectivesTo develop a mediastinal shift angle (MSA) measurement method applicable to right-sided congenital diaphragmatic hernia (RCDH) in fetal MRI and to validate the predictive value of MSA in RCDH.

methodsTwenty-seven fetuses with isolated RCDH and 53 controls were included in our study. MSA was measured on MRI axial image at the level of four-chamber view of the fetal heart. The angle between the sagittal midline landmark line and the left boundary landmark line touching tangentially the lateral wall of the left ventricle was used to quantify MSA for RCDH. Appropriate statistical analyses were performed to determine whether MSA can be regarded as a valid predictive tool for postnatal outcomes. Furthermore, predictive performance of MSA was compared with that of lung area to head circumference ratio (LHR), observed/expected LHR (O/E LHR), total fetal lung volume (TFLV), and observed/expected TFLV (O/E TFLV).

resultsMSA was significantly higher in the RCDH group than in the control group. MSA, LHR, O/E LHR, TFLV, and O/E TFLV were all correlated with postnatal survival, pulmonary hypertension (PH), and extracorporeal membrane oxygenation (ECMO) therapy (p < 0.05). Value of the AUC demonstrated good predictive performance of MSA for postnatal survival (0.901, 95%CI: (0.781-1.000)), PH (0.828, 95%CI: (0.661-0.994)), and ECMO therapy (0.813, 95%CI: (0.645-0.980)), which was similar to O/E TFLV but slightly better than TFLV, O/E LHR, and LHR.

conclusionsWe developed a measurement method of MSA for RCDH for the first time and demonstrated that MSA could be used to predict postnatal survival, PH, and ECMO therapy in RCDH. CLINICAL RELEVANCE STATEMENT: Newly developed MRI assessment method of fetal MSA in RCDH offers a simple and effective risk stratification tool for patients with RCDH. KEY POINTS: • We developed a measurement method of mediastinal shift angle for right-sided congenital diaphragmatic hernia for the first time and demonstrated its feasibility and reproducibility. • Mediastinal shift angle can predict more prognostic information other than survival in right-sided congenital diaphragmatic hernia with good performance. • Mediastinal shift angle can be used as a simple and effective risk stratification tool in right-sided congenital diaphragmatic hernia to improve planning of postnatal management.

Indexed as

Hernias, Diaphragmatic, CongenitalHypertension, PulmonaryFemaleHumansLungLung Volume MeasurementsMagnetic Resonance ImagingPregnancyReproducibility of ResultsRetrospective StudiesRisk AssessmentUltrasonography, PrenatalCongenital diaphragmatic herniaExtracorporeal membrane oxygenationMagnetic resonance imagingMediastinumPulmonary hypertension

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.