MR prediction of postnatal outcomes in left-sided congenital diaphragmatic hernia using right lung signal intensity: Comparison with that using right lung volume

Purpose: 1To investigate the validity of the fetal right lungto-liver signal intensity ratio (LLSIR) for prediction of postnatal outcomes in left-sided congenital diaphragmatic hernia (CDH). Materials and Methods: The study included 14 pregnant women who underwent MR exams for evaluation of fetal left-sided CDH. The fetuses were divided into two groups: Group A (n = 9), alive, and Group B (n = 5), dead. On the basis of the half-Fourier acquisition single-shot turbo spinecho sequence, LLSIR and the right fetal lung volume (FLV) was calculated. In the control group, a regression analysis was performed to associate LLSIR and right FLV with gestational age. The relative LLSIR and right FLV (the observed/ expected LLSIR and right FLV) were compared between Groups A and B. Results: The mean relative LLSIR, as well as the mean relative right FLV, of Group A was significantly higher than that of Group B (p = 0.035). Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for the relative LLSIR and the relative right FLV, when the cutoff point was defined as 0.646 and 0.420, were the same and were 88.9%, 80.0%, 88.9%, 80.0%, and 85.7%, respectively. Conclusion: The postnatal outcomes in left-sided CDH may be predicted using the LLSIR.