Fetal Cervical Teratoma: What Is the Role of Fetal MRI in Predicting Pulmonary Hypoplasia?Wolfe K. · Lewis D. · Witte D. · Kline-Fath B. · Lim F.-Y. · Jaekle R. · Habli M. · Hostiuck J. · Baregamian N. · Keswani S. · Crombleholme T.
aUniversity of Cincinnati College of Medicine and bCincinnati Children's Hospital Medical Center, Cincinnati, Ohio, cUniversity of South Alabama, Mobile, Alabama, Ala., and dUniversity of Colorado School of Medicine, Aurora, Colo., USA
Objective: To determine whether total fetal lung volumes estimated by MRI could predict lethal pulmonary hypoplasia in a cohort of fetuses with cervical teratomas. Methods: We performed a retrospective cohort study of fetal cervical teratomas from January 1, 2005, through April 1, 2012. The primary outcome was the ability of total lung volumes measured by MRI to predict neonatal mortality specifically due to pulmonary hypoplasia. Measured lung volumes were compared to previously reported normal values. The percent of observed-to-expected lung volume and the percent predicted lung volume were calculated. The positive and negative predictive values were calculated for each variable. Results: Fetal MRI-derived total lung volumes 1 standard deviation below the median for gestational age had a positive predictive value of 100% in predicting lethal pulmonary hypoplasia. Conversely, total lung volumes above this level were uniformly associated with pulmonary survival (100% negative predictive value). Additionally, percent predicted lung volume ≤75.7 and observed-to-expected lung volume ≤68.3 were associated with lethal pulmonary hypoplasia. Conclusion: In this small cohort, MRI-estimated lung volumes were helpful in predicting the presence of pulmonary hypoplasia complicating fetal cervical teratoma.
Timothy M. Crombleholme, MD, Colorado Fetal Care Center
Children's Hospital Colorado, Division of Pediatric General Thoracic and
Fetal Surgery, University of Colorado School of Medicine
Anschutz Medical Campus, 13123 East 16th Ave, Aurora, CO 80045 (USA)
The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.
Received: May 21, 2012
Accepted after revision: July 25, 2012
Published online: February 21, 2013
Number of Print Pages : 5
Number of Figures : 1, Number of Tables : 1, Number of References : 15
Fetal Diagnosis and Therapy (Clinical Advances and Basic Research)
Vol. 33, No. 4, Year 2013 (Cover Date: May 2013)
Journal Editor: Gratacós E. (Barcelona)
ISSN: 1015-3837 (Print), eISSN: 1421-9964 (Online)
For additional information: http://www.karger.com/FDT