Klin Padiatr 2023; 235(02): 132
DOI: 10.1055/s-0043-1761572
Abstracts | GPP
17. März 2023
V-02 | Kurzvorträge
10:30 – 12:00 SH 0.101

Side-specific diagnostic of lung ventilation and perfusion using functional matrix-pencil decomposition (MP-)MRI versus global lung function tests in children with congential diaphragmatic hernia

Carrmen Streibel
1   Inselspital, Universitätsklinik für Kinderheilkunde, Division of Paediatric Respiratory Medicine and Allergology, Department of Peadiadrics, Bern, Schweiz
,
Christoph C. Willers
1   Inselspital, Universitätsklinik für Kinderheilkunde, Division of Paediatric Respiratory Medicine and Allergology, Department of Peadiadrics, Bern, Schweiz
5   Kantonsspital Aarau, Department of Pediatrics, Aarau, Schweiz
,
Grzegorz Bauman
2   University of Basel Hospital, Department of Radiology, Division of Radiological Physics, Basel, Schweiz
3   University of Basel, Department of Biomedical Engineering, Basel, Schweiz
,
Orso Pusterla
1   Inselspital, Universitätsklinik für Kinderheilkunde, Division of Paediatric Respiratory Medicine and Allergology, Department of Peadiadrics, Bern, Schweiz
2   University of Basel Hospital, Department of Radiology, Division of Radiological Physics, Basel, Schweiz
3   University of Basel, Department of Biomedical Engineering, Basel, Schweiz
,
Oliver Bieri
2   University of Basel Hospital, Department of Radiology, Division of Radiological Physics, Basel, Schweiz
3   University of Basel, Department of Biomedical Engineering, Basel, Schweiz
,
Marion Curdy
1   Inselspital, Universitätsklinik für Kinderheilkunde, Division of Paediatric Respiratory Medicine and Allergology, Department of Peadiadrics, Bern, Schweiz
,
Matthias Horn
1   Inselspital, Universitätsklinik für Kinderheilkunde, Division of Paediatric Respiratory Medicine and Allergology, Department of Peadiadrics, Bern, Schweiz
,
Carmen Casaulta
1   Inselspital, Universitätsklinik für Kinderheilkunde, Division of Paediatric Respiratory Medicine and Allergology, Department of Peadiadrics, Bern, Schweiz
,
Steffen Berger
4   Inselspital, Universitätsklinik für Kinderheilkunde, Department of Paediatric Surgery, Bern, Schweiz
,
Gabriela M. Dekany
4   Inselspital, Universitätsklinik für Kinderheilkunde, Department of Paediatric Surgery, Bern, Schweiz
,
Elisabeth Kieninger
1   Inselspital, Universitätsklinik für Kinderheilkunde, Division of Paediatric Respiratory Medicine and Allergology, Department of Peadiadrics, Bern, Schweiz
,
Andreas Bartenstein
4   Inselspital, Universitätsklinik für Kinderheilkunde, Department of Paediatric Surgery, Bern, Schweiz
,
Philipp Latzin
1   Inselspital, Universitätsklinik für Kinderheilkunde, Division of Paediatric Respiratory Medicine and Allergology, Department of Peadiadrics, Bern, Schweiz
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Background In patients with congenital diaphragmatic hernia (CDH) the exact functional outcome of the affected lung side is still unknown, mainly due to the lack of spatially resolved diagnostic tools. Functional matrix-pencil decomposition (MP-) lung MRI could fill this gap as it measures side-specific ventilation and perfusion.

Objective To assess the overall and side-specific pulmonary long-term outcome of patients with CDH using lung function tests and functional MP-MRI.

Methods Thirteen school aged children with CDH (seven with a small and six with a large defect-sized CDH defined as>50% of the chest wall circumference being devoid of diaphragm tissue) and thirteen healthy controls (sex- and age-matched) underwent spirometry, multiple breath washout and MP-MRI. Main outcomes were forced expiratory volume in 1 second (FEV1), lung clearance index (LCI), ventilation defect percentage (VDP), perfusion defect percentage (QDP). We compared outcomes between groups using ANOVA.

Results Patients with a large CDH showed significantly reduced overall lung function compared to healthy controls [mean difference; 95%-CIadjusted.: FEV1 (z-score) -4.26 (-5.61 to -2.92), LCI2.5 (TO) 1.12 (0.47 to 1.76), VDP (%) 8.59 (3.58 to 13.60), QDP (%) 17.22 (13.16 to 21.27)] and to patients with a small CDH. Side-specific examination by MP-MRI revealed particularly reduced ipsilateral ventilation and perfusion in patients with a large CDH [mean difference to contralateral side; 95%-CIadjusted.: VDP (%) 14.80 (10.50 to 19.00), QDP (%) 23.50 (1.75 to 45.20)].

Conclusions Patients with a large CDH showed impaired overall lung function with particular limitation of the ipsilateral side. MP-MRI is a promising tool to provide valuable side-specific functional information in the follow-up of patients with CDH.



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Artikel online veröffentlicht:
09. März 2023

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