Journal Mobile Options
Table of Contents
Vol. 33, No. 4, 2013
Issue release date: May 2013
Fetal Diagn Ther 2013;33:252-256
(DOI:10.1159/000342191)

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

Individual Users: Register with Karger Login Information

Please create your User ID & Password





Contact Information











I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in

Abstract

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.



Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

References

  1. Stevens GH, Schoot BC, Smets MJ, et al: The ex utero intrapartum treatment (EXIT) procedure in fetal neck masses: a case report and review of the literature. Eur J Obstet Gynecol Reprod Biol 2002;100:246-250.
  2. Tonni G, De Felice C, Centini G, Ginanneschi C: Cervical and oral teratoma in the fetus: a systematic review of etiology, pathology, diagnosis, treatment and prognosis. Arch Gynecol Obstet 2010;282:355-361.
  3. Liechty KW, Crombleholme TM, Flake AW, et al: Intrapartum airway management for giant fetal neck masses: the EXIT (ex utero intrapartum treatment) procedure. Am J Obstet Gynecol 1997;177:870-874.
  4. Bianchi DW, Crombleholme TM, D'Alton ME, Malone FD: Cervical teratoma; in Fetology: Diagnosis and Management of the Fetal Patient, ed 2.. New York, McGraw-Hill, 2010, pp 751-757.
  5. Liechty KW, Hedrick HL, Hubbard AM, et al: Severe pulmonary hypoplasia associated with giant cervical teratomas. J Pediatr Surg 2006;41:230-233.
  6. Jani J, Cannie M, Sonigo P, et al: Value of prenatal magnetic resonance imaging in the prediction of postnatal outcome in fetuses with diaphragmatic hernia. Ultrasound Obstet Gynecol 2008;32:793-799.
  7. Bonfils M, Emeriaud G, Durand C, et al: Fetal lung volume in congenital diaphragmatic hernia. Arch Dis Child Fetal Neonatal Ed 2006;91:F363-F364.
  8. Zaretsky M, Ramus R, McIntire D, Magee K, Twickler DM: MRI calculation of lung volumes to predict outcome in fetuses with genitourinary abnormalities. AJR Am J Roentgenol 2005;185:1328-1334.
  9. Gorincour G, Bouvenot J, Mourot MG, et al: Prenatal prognosis of congenital diaphragmatic hernia using magnetic resonance imaging measurement of fetal lung volume. Ultrasound Obstet Gynecol 2005;26:738-744.
  10. Barnewolt CE, Kunisaki SM, Fauza DO, Nemes LP, Estroff JA, Jennings RW: Percent predicted lung volumes as measured on fetal magnetic resonance imaging: a useful biometric parameter for risk stratification in congenital diaphragmatic hernia. J Pediatr Surg 2007;42:193-197.
  11. Terui K, Omoto A, Osada H, et al: Prediction of postnatal outcomes in congenital diaphragmatic hernia using MRI signal intensity of the fetal lung. J Perinatol 2011;31:269-273.
  12. Matsushita M, Ishii K, Tamura M, et al: Perinatal magnetic resonance fetal lung volumetry and fetal lung-to-liver signal intensity ratio for predicting short outcome in isolated congenital diaphragmatic hernia and cystic adenomatoid malformation of the lung. J Obstet Gynaecol Res 2008;34:162-167.
  13. Kilian AK, Busing KA, Schuetz EM, Schaible T, Neff KW: Fetal MR lung volumetry in congenital diaphragmatic hernia (CDH): prediction of clinical outcome and the need for extracorporeal membrane oxygenation (ECMO). Klin Pädiatr 2009;221:295-301.
  14. Rypens F, Metens T, Rocourt N, et al: Fetal lung volume: estimation at MR imaging-initial results. Radiology 2001;219:236-241.

    External Resources

  15. Hirose S, Sydorak RM, Tsao K, et al: Spectrum of intrapartum management strategies for giant fetal cervical teratoma. J Pediatr Surg 2003;38:446-450; discussion 450.


Pay-per-View Options
Direct payment This item at the regular price: USD 38.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 26.50