The lung to thorax transverse area ratio has a linear correlation with the observed to expected lung area to head circumference ratio in fetuses with congenital diaphragmatic hernias

J Pediatr Surg. 2014 Aug;49(8):1191-6. doi: 10.1016/j.jpedsurg.2013.10.021. Epub 2013 Nov 7.

Abstract

Background/purpose: The purpose of this study was to clarify the relationship between the lung to thorax transverse area ratio (L/T ratio) and the observed to expected lung area to head circumference ratio (O/E LHR), based on the results of a nationwide Japanese survey conducted in 2011, and to evaluate the compatibility of these prognostic predictors of fetal CDH.

Methods: Two hundred and forty-two prenatally diagnosed isolated CDH patients born between 2006 and 2010 were included in the present analysis. A regression analysis was conducted to investigate the relationship between the L/T ratio and the O/E LHR based on 191 simultaneous measurements of these parameters in 120 patients.

Results: The linear regression equation between the L/T ratio and the O/E LHR was: L/T ratio=0.0233+(0.00222×O/E LHR), (R=0.847, p<0.0001). According to this equation, 25% of the O/E LHR, the cut-off value used in the fetal intervention for CDH, was equivalent to an L/T ratio of 0.08, a commonly accepted cut-off value for identifying the most severe cases of fetal CDH.

Conclusions: As there is a positive correlation between the L/T ratio and the O/E LHR, these two parameters proved to be used interchangeably according to the linear regression equation.

Keywords: Congenital diaphragmatic hernia; Predictive parameter; Prenatal diagnosis; Prognostic factor; Pulmonary hypoplasia.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cephalometry / methods*
  • Female
  • Fetal Diseases / diagnosis*
  • Fetal Diseases / epidemiology
  • Follow-Up Studies
  • Gestational Age
  • Hernias, Diaphragmatic, Congenital / diagnosis
  • Hernias, Diaphragmatic, Congenital / embryology*
  • Hernias, Diaphragmatic, Congenital / epidemiology
  • Humans
  • Incidence
  • Infant, Newborn
  • Japan / epidemiology
  • Lung / embryology*
  • Lung Volume Measurements
  • Male
  • Pregnancy
  • Prenatal Diagnosis
  • ROC Curve
  • Retrospective Studies