Prognostic usefulness of derived T2-weighted fetal magnetic resonance imaging measurements in congenital diaphragmatic hernia

array:22 ["pii" => "S2173510715000257" "issn" => "21735107" "doi" => "10.1016/j.rxeng.2014.02.006" "estado" => "S300" "fechaPublicacion" => "2015-05-01" "aid" => "728" "copyright" => "SERAM" "copyrightAnyo" => "2013" "documento" => "article" "subdocumento" => "fla" "cita" => "Radiologia. 2015;57:239-47" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 868 "formatos" => array:2 [ "HTML" => 589 "PDF" => 279 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0033833814000344" "issn" => "00338338" "doi" => "10.1016/j.rx.2014.02.001" "estado" => "S300" "fechaPublicacion" => "2015-05-01" "aid" => "728" "copyright" => "SERAM" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Radiologia. 2015;57:239-47" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1331 "formatos" => array:3 [ "EPUB" => 18 "HTML" => 877 "PDF" => 436 ] ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "Original" "titulo" => "Cuantificación de la señal T2 pulmonar por resonancia magnética como factor pronóstico en las hernias diafragmáticas congénitas fetales" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "239" "paginaFinal" => "247" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Prognostic usefulness of derived T2-weighted fetal magnetic resonance imaging measurements in congenital diaphragmatic hernia" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0020" "etiqueta" => "Figura 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 1124 "Ancho" => 1405 "Tamanyo" => 91912 ] ] "descripcion" => array:1 [ "es" => "Imagen sagital en T2 que corresponde al pulmón contralateral a una hernia diafragmática congénita izquierda (flecha) de un feto de 35 semanas con un cociente de intensidad de señal pulmón-hígado (LLSR) de 3,7 y un cociente de intensidad de señal pulmón-líquido cefalorraquídeo (L/SF SR) de 0,87, con excelente evolución posnatal." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "C. Sebastià, O. Gomez, R. Salvador, L. Buñesch, R. Garcia, C. Nicolau" "autores" => array:6 [ 0 => array:2 [ "nombre" => "C." "apellidos" => "Sebastià" ] 1 => array:2 [ "nombre" => "O." "apellidos" => "Gomez" ] 2 => array:2 [ "nombre" => "R." "apellidos" => "Salvador" ] 3 => array:2 [ "nombre" => "L." "apellidos" => "Buñesch" ] 4 => array:2 [ "nombre" => "R." "apellidos" => "Garcia" ] 5 => array:2 [ "nombre" => "C." "apellidos" => "Nicolau" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2173510715000257" "doi" => "10.1016/j.rxeng.2014.02.006" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173510715000257?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0033833814000344?idApp=UINPBA00004N" "url" => "/00338338/0000005700000003/v2_201504220437/S0033833814000344/v2_201504220437/es/main.assets" ] ] "itemAnterior" => array:18 [ "pii" => "S2173510715000269" "issn" => "21735107" "doi" => "10.1016/j.rxeng.2014.01.001" "estado" => "S300" "fechaPublicacion" => "2015-05-01" "aid" => "729" "copyright" => "SERAM" "documento" => "article" "subdocumento" => "fla" "cita" => "Radiologia. 2015;57:229-38" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 830 "formatos" => array:2 [ "HTML" => 595 "PDF" => 235 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "Original Report" "titulo" => "Is the performance of MRI in preoperative staging of breast cancer independent of clinical and histological factors? A subgroup analysis" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "229" "paginaFinal" => "238" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "El rendimiento de la RM en la estadificación preoperatoria del carcinoma de mama sería independiente de factores clínicos y patológicos: análisis de subgrupos" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1419 "Ancho" => 1000 "Tamanyo" => 185425 ] ] "descripcion" => array:1 [ "en" => "Multifocal infiltrating ductal carcinoma. Main lesion (white arrow) with multiple satellite foci. Focus at more than 1cm of the main one (arrowhead) (a). Infiltrating ductal carcinoma (arrow), asymmetrical enhancement of the nipple and subareolar region (arrow). The multicentric lesion was confirmed in the ultrasound-guided biopsy (b)." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "C. Carreira Gómez, J. Zamora Romero, A. Gil de Miguel, M. Chiva de Agustín, M.N. Plana Farrás, J. Martínez González" "autores" => array:6 [ 0 => array:2 [ "nombre" => "C." "apellidos" => "Carreira Gómez" ] 1 => array:2 [ "nombre" => "J." "apellidos" => "Zamora Romero" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "Gil de Miguel" ] 3 => array:2 [ "nombre" => "M." "apellidos" => "Chiva de Agustín" ] 4 => array:2 [ "nombre" => "M.N." "apellidos" => "Plana Farrás" ] 5 => array:2 [ "nombre" => "J." "apellidos" => "Martínez González" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0033833814000356" "doi" => "10.1016/j.rx.2014.01.002" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0033833814000356?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173510715000269?idApp=UINPBA00004N" "url" => "/21735107/0000005700000003/v2_201504291245/S2173510715000269/v2_201504291245/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "Original Report" "titulo" => "Prognostic usefulness of derived T2-weighted fetal magnetic resonance imaging measurements in congenital diaphragmatic hernia" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "239" "paginaFinal" => "247" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "C. Sebastià, O. Gomez, R. Salvador, L. Buñesch, R. Garcia, C. Nicolau" "autores" => array:6 [ 0 => array:4 [ "nombre" => "C." "apellidos" => "Sebastià" "email" => array:1 [ 0 => "msebasti@clinic.ub.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "O." "apellidos" => "Gomez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "R." "apellidos" => "Salvador" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "L." "apellidos" => "Buñesch" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 4 => array:3 [ "nombre" => "R." "apellidos" => "Garcia" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] 5 => array:3 [ "nombre" => "C." "apellidos" => "Nicolau" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Departamento de Radiología (CDI), Hospital Clínic, Barcelona, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Departamento de Ginecología y Obstetricia (ICGON), Hospital Clínic, Barcelona, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Cuantificación de la señal T2 pulmonar por resonancia magnética como factor pronóstico en las hernias diafragmáticas congénitas fetales" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0020" "etiqueta" => "Figure 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 1041 "Ancho" => 1301 "Tamanyo" => 98521 ] ] "descripcion" => array:1 [ "en" => "T2-weighted sagittal image corresponding to the contralateral lung of one left congenital diaphragmatic hernia (arrow) of a 35-week old fetus with a lung to liver signal ratio (LLSR) of 3.7 and a lung to spinal fluid signal ratio (L/SF SR) of 0.87 with an excellent postnatal evolution." ] ] ] "textoCompleto" => "IntroductionThe right growth and maturation of fetal lungs are key in the post-natal period. The processes compressing the chest cavity such as the congenital diaphragmatic hernia (CDH) and the oligohidramnios can affect the development of fetal lungs leading the pulmonary hypoplasis and secondary pulmonary hypertesions.<a class="elsevierStyleCrossRef" href="#bib0125">1</a> The fetal pulmonary evaluation in fetuses with CDH is usually done through ultrasound even though recently the utility of magnetic resonance imaging (MRI)<a class="elsevierStyleCrossRef" href="#bib0125">1</a> has been confirmed. The most valued ultrasound prognostic indicator for the assessment of pulmonary development is the ratio between the observed value and the observed-to-expected lung area to head circumference ratio O/E LHR.<a class="elsevierStyleCrossRef" href="#bib0125">1</a> Also the Doppler echographic parameters of the pulmonary artery and pulmonary perfusion can be studied which will tell us, respectively, if there is pulmonary hypertension and how the intrapulmonary vascularization really is–indirect signs of pulmonary hypoplasia.<a class="elsevierStyleCrossRefs" href="#bib0130">2,3</a> The location of the liver in the thorax–inside the CDH is an independent sign of poor neonatal prognosis correlated with the degree of hypoplasia.<a class="elsevierStyleCrossRef" href="#bib0125">1</a> These data can be assessed echographically yet it is recommended to study it through MRIs since the liver is better differentiated from other organs and adjacent structures that are similar echographically.<a class="elsevierStyleCrossRef" href="#bib0140">4</a> There are other MRI parameters that can help us study pulmonary hyperplasia, while most of them are based on the volume like the homo and/or contralateral relative pulmonary volume, the percentage of herniated liver or the gastric location of the hernia–all of them indirectly reporting about pulmonary compression due to the mass effect of hernia.<a class="elsevierStyleCrossRefs" href="#bib0140">4–6</a> Recently other parameters of fetal pulmonary imaging providing qualitative data of pulmonary maturation have been reported like the relative pulmonary signal in T2 and T2-weighted MRIs, diffusion-weighted and spectroscopic MRIs or ultrasound-based images on pulmonary texture–useful to distinguish normal from hypoplasic lungs.<a class="elsevierStyleCrossRefs" href="#bib0155">7–9</a>The goal of this study is to determine the neonatal prognosis of CDH from the contralateral lung relative signal in T2-weighted fast sequences of fetal MRIs.Materials and methodsPatientsFrom January 2006 to December 2011, 79 pregnant women with fetuses echographically diagnosed with CDH were seen in our center. All of them were studied through fetal ultrasound and MRI as part of the study protocol for CDH. The sample consisted of patients from the very hospital care units and patients from other hospitals sent to our center. Among them, 50 met the criteria for fetal endoscopic tracheal occlusion of which 43 underwent surgery and were excluded from the study while in the remaining seven the pregnancy was interrupted. The 29 patients who did not receive any therapies went on with their pregnancies and they made up the study sample. In all patients delivery took place in our center except for four cases that due to their good prenatal prognosis were referred to their corresponding centers of reference. One case was eliminated from the study due to lack of postnatal data. The final number of patients included in the study was therefore 28 whose characteristics can be seen in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>. No fetus showed other congenital or chromosomic malformations. This work is a part of a wider investigational protocol approved by our hospital ethical committee.<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>Image modalitiesThe ultrasounds were obtained through the Siemens Sonoline Antares (Siemens Medical Systems, Malvern, PA, USA) or Voluson 730 Expert ultrasound scanners (GE Medical Systems, Milwaukee, WI, USA) following the usual technique.<a class="elsevierStyleCrossRef" href="#bib0125">1</a>The MRIs were acquired through a 1.5 Tesla machine (Magneton Symphony, Siemens Medical Systems, Erlangen, Germany) using a 6-channel coil. The patient was placed in the decubitus supine position always under sedation. The patient never received corticoids before the MRI. The T2-weighted sequences were obtained through a half-Fourier acquisition single-shot turbo spin-echo (HASTE) sequence in the axial, coronal and sagittal planes orthogonal to the fetus of 5mm thickness without overlapping, FOV 380mm×380mm, matrix 173×256, TR/TE=1.000/88ms, a partial Fourier factor of 5/8 for a pixel resolution of 2.2mm×1.5mm×4mm, and a 475Hz/pixel bandwidth.The echographic data were collected retrospectively from the fetal ultrasound report (O/E LHR and hepatic location) and one 5-year experienced radiologist in fetal MRIs who did not know about the postnatal evolution of fetuses evaluated hepatic location and drew the regions of interest (ROI) in lung, liver, and cephalo-rachidian liquid (CRL) in the T2-weighted sequences. For the assessment of the contralateral pulmonary signal we followed the most popular method described in literature by Kuwasima and then reproduced by Brewerton and Balassy.<a class="elsevierStyleCrossRefs" href="#bib0170">10–12</a> Three measurements of the lung contralateral to the hernia while avoiding vessels and bronchi were taken with an ROI between 0.5 and 2mm2, and three ROIs in the liver also avoiding the hepatic vessels of between 1.5 and 3mm2. The pulmonary and liver measurements were taken in the same cut in one axial or sagittal image choosing both the plane and image with the least possible artifacts. The average of the three pulmonary measurements divided by the average of the three hepatic measurements is called the LLSR (lung to liver signal ratio) (<a class="elsevierStyleCrossRefs" href="#fig0005">Figs. 1 and 2</a>). For the measurement of the CRL signal the axial plane was used in which no artifacts were seen while measuring the lung as described before and also drawing three ROIs in the CRL while avoiding the bone marrow and proximal bones of between 0.1 and 1mm2 (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>). The average of the three pulmonary measurements divided by the average of the three CRL measurements is called the L/SF SR (lung to spinal fluid signal ratio).<elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia>We studied the correlation between the echographic prenatal parameters (liver located above or under the diaphragm and O/E LHR) and the MRI-based echographic prenatal parameters (LLSR and L/SF SR) and the existence–or not of pulmonary hypertension assessed through echocardiography, also the postnatal survival (death before or after the first 45 days from delivery attributable to CDH), the need for oxygen (> or <30 days), and the need–or not for extracorporeal membrane oxygenation (ECMO) (<a class="elsevierStyleCrossRefs" href="#fig0020">Figs. 4 and 5</a>).<elsevierMultimedia ident="fig0020"></elsevierMultimedia><elsevierMultimedia ident="fig0025"></elsevierMultimedia>Statistical analysisThe quantitative variables were described as maximum, minimum, median and interquartile ranges and compared with the non-parametric Mann–Whitney U test. The quantitative variables were described as absolute and relative frequencies and analyzed through the Fischer's exact test.To obtain a cutting point of variables LLSR and L/SF SR the positive coefficient of probability (CP+) for mortality was assessed and defined as the ratio sensitivity/(1−especificity). Compared with an ROC analysis the value of CP+ in this study allows us to quantify the goodness of the cutting point proposed because the ratio of CP+ also expresses the relation of true positives vs false negatives for a determined cutting point.The statistical analysis was performed through the SPSS 20 software (IBM) using a type I error rate of 5% bilateral. p<0.05 was considered significant.ResultsIn the 28 cases we had the O/E LHR and the ultrasound-based hepatic location and the measurements of the contralateral, hepatic pulmonary signal and that of the CRL. In summary, the results can be seen in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>. In 27 out of 28 cases we had information on the need–or not for ECMO. In one case in which delivery happened outside the hospital we did not have the corresponding information so the total number of cases in which we compared the radiologic findings with the need for ECMO was 27. In 20 of the 28 cases we knew exactly the number of days during which the newly born baby needed oxygen. In the 28 cases we could assess postnatal survival and the diagnosis of pulmonary hypertension.<elsevierMultimedia ident="tbl0010"></elsevierMultimedia>Among all of the assessed data only the relation between O/E LHR and the need for postnatal ECMO (p=0.033) and between O/E LHR and LLSR and postnatal survival (p=0.01 and p=0.039, respectively) were statistically significant. There was no significant relation between the hepatic location or the L/SF SR with any of the postnatal parameters. Neither between the LLSR and the need for oxygen, ECMO or pulmonary hypertension. The LLSR cutting point between survivors and non-survivors was 2.2 with a CP+=2.7; and 0.52 for L/SF SR, with a CP+=3.7.DiscussionIn our study we proved that even though the most consistent parameter to predict postnatal prognosis like several studies ratify<a class="elsevierStyleCrossRefs" href="#bib0125">1,6</a> is the echographic O/E LHR there is also a statistically significant relation between the highest values of LLSR and the postnatal survival beyond 45 days. Assessing the degree of pulmonary hypoplasia in fetuses with CDH is very important for prenatal advice and to predict postnatal evolution. One-third of the newly born babies with CDH will die from pulmonary hyperplasia and/or pulmonary hypertension.<a class="elsevierStyleCrossRef" href="#bib0185">13</a>Being able to diagnose correctly prenatal pulmonary hypoplasia with image modalities is still a challenge. Today the ultrasound-assessed O/E LHR is considered to be the most consistently correlated parameter with the postnatal prognosis in fetuses with CDH.<a class="elsevierStyleCrossRef" href="#bib0125">1</a> MRIs allow us to study the chemical and structural characteristics of several tissues. Studies published on animal and human experimentation have analyzed the relation between the signal intensity and the pulmonary structure.<a class="elsevierStyleCrossRefs" href="#bib0185">13–16</a> There is a significant positive correlation between the T2-weighted signal of healthy lungs and gestational age and there are no significant differences between the signal of the two lungs in healthy fetuses. Different formulae have been proposed to be able to calculate the pulmonary signal intensity in healthy fetuses based on gestational age.<a class="elsevierStyleCrossRefs" href="#bib0185">13,14,16</a>Pulmonary hypoplasia is defined anatomopathologically as the shrinking of airways and the number of alveoli with respect to a normal lung.<a class="elsevierStyleCrossRef" href="#bib0205">17</a> Even though the pathogenesis is not clear yet the pulmonary liquid can have an important role in pulmonary development. Lungs with a significant hyperintensity in the T2-weighted sequences are normal while those highly hypointense are hypoplasic while a cutting value for LLSR=2 can help us distinguish hypoplasic from normal lungs.<a class="elsevierStyleCrossRef" href="#bib0170">10</a> This statement is only valid from the gestational week #26–not earlier because the production of liquid in the fetus lungs starts in the second quarter when the pulmonary interstitium refines gradually.<a class="elsevierStyleCrossRefs" href="#bib0160">8,11</a> All these have to do with the anatomic studies that consider that the pulmonary development and maturation in the canalicular and alveolar phases are similar in normal and hypoplasic lungs.<a class="elsevierStyleCrossRef" href="#bib0210">18</a> On the other hand, the pulmonary signal of lungs compressed due to CDH is very similar to that of the contralateral lung suggesting that the hernia contralateral signal can be a good marker of global pulmonary signal.<a class="elsevierStyleCrossRef" href="#bib0215">19</a>MRI-based signal intensity of any tissues depends on the sequence used and the distance to the coil–this is why absolute values are not appropriate to assess this. This is why structures at a similar depth are used as a reference. These structures can be the liver, the CRL and the amniotic fluid. To be able to estimate the ratio between the intensity of pulmonary signal and that of a reference structure this second structure should not experience changes with gestational age. The liver signal changes based on pregnancy probably due to the progressive increase of the concentrations of iron and the progressive reduction in the production of hemoglobin<a class="elsevierStyleCrossRef" href="#bib0220">20</a> and can be an excellent parameter of reference. Yet these differences were studied in the 20 and 26th weeks of pregnancy not later. The CRL however does not experience any changes during pregnancy.<a class="elsevierStyleCrossRef" href="#bib0190">14</a>There are very few studies showing the efficacy of measuring the T2-weighted pulmonary signal intensity in fetuses with CDH and its relation to pulmonary hypoplasia and the fetal postnatal prognosis and all of them are based in very few cases and use different methods (<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>). Even though it is well known that the hepatic signal varies with gestational age before the 25th week of pregnancy most studies support the LLSR,<a class="elsevierStyleCrossRefs" href="#bib0165">9,11,12,21,22</a> while other studies have valued the L/SF SR<a class="elsevierStyleCrossRefs" href="#bib0190">14–23</a> with contradictory results. Even though no significant differences between the L/SF SR of newly born babies with good or poor prognosis have been found in our study, there is a trend that patients with poor prognosis have a lower ratio with an average signal in these cases similar to that of previous studies of around 0.65. Similarly the differences among patients with good or poor prognosis and the LLSR cutting level are also similar to that of previous studies (around 2).<a class="elsevierStyleCrossRefs" href="#bib0160">8,24</a><elsevierMultimedia ident="tbl0015"></elsevierMultimedia>Our study has some limitations. It is a retrospective study with a small sample yet it needs to be reminded that it is an uncommon process and that our series is the largest one ever published. Another limitation of this study is that the measurement of signal intensity was taken by one radiologist only and we did not calculate the variability induced by the observer. Also in daily routine it is hard to draw one relatively big ROI in the CRL without including the bone marrow or the adjacent vertebra. The possible error of measurement can be the reason for the lack of conclusive results in our study with L/SF SR. Also the signal intensity among images and sequences has been extremely variable. However measurement variability is solved by estimating the ratio. A third limitation is that our sample is biased because mid-and-high risk patients who met the criteria for fetal endoscopic tracheal occlusion underwent surgery and we only have the natural evolution of those fetuses that were not candidates to undergo fetal endoscopic tracheal occlusion or mothers who refused this therapy and moved on with their pregnancy.In summary, our study shows that the LLSR is a parameter correlated with postnatal survival in fetuses with CDH that potentially can be used as a prognostic parameter in the fetal study of CDH.Ethical responsibilitiesProtection of people and animalsAuthors confirm that no experiments have been performed on human beings or animals.Data confidentialityAuthors confirm that the protocols of their institution have been followed on the publication of data from patients.Right to privacy and informed consentAuthors confirm that in this report there are no personal data from patients.Authors’ contribution<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005">1.Manager of the integrity of the study: CS.</li><li class="elsevierStyleListItem" id="lsti0010">2.Original idea of the study: CS, OG, CN.</li><li class="elsevierStyleListItem" id="lsti0015">3.Study design: CS.</li><li class="elsevierStyleListItem" id="lsti0020">4.Data mining: CS, OG, RG, RS, LB, CN.</li><li class="elsevierStyleListItem" id="lsti0025">5.Data analysis and interpretation: CS, OG, RG, RS, LB, CN.</li><li class="elsevierStyleListItem" id="lsti0030">6.Statistical analysis: RS.</li><li class="elsevierStyleListItem" id="lsti0035">7.Reference search: CS, OG, RG, RS, LB, CN.</li><li class="elsevierStyleListItem" id="lsti0040">8.Writing: CS, OG, RG, RS, LB, CN.</li><li class="elsevierStyleListItem" id="lsti0045">9.Critical review: CS, OG, RG, RS, LB, CN.</li><li class="elsevierStyleListItem" id="lsti0050">10.Approval of final version: CS, OG, RG, RS, LB, CN.</li></ul>Conflict of interestsDr. Carmen Sebastià, MD received a research grant from SERAM Industria. The remaining authors reported no conflicts of interests." "textoCompletoSecciones" => array:1 [ "secciones" => array:12 [ 0 => array:3 [ "identificador" => "xres490304" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Materials and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec512377" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres490303" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivo" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Material y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec512376" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Materials and methods" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Patients" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Image modalities" ] 2 => array:2 [ "identificador" => "sec0025" "titulo" => "Statistical analysis" ] ] ] 6 => array:2 [ "identificador" => "sec0030" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0035" "titulo" => "Discussion" ] 8 => array:3 [ "identificador" => "sec0040" "titulo" => "Ethical responsibilities" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0045" "titulo" => "Protection of people and animals" ] 1 => array:2 [ "identificador" => "sec0050" "titulo" => "Data confidentiality" ] 2 => array:2 [ "identificador" => "sec0055" "titulo" => "Right to privacy and informed consent" ] ] ] 9 => array:2 [ "identificador" => "sec0060" "titulo" => "Authors’ contribution" ] 10 => array:2 [ "identificador" => "sec0065" "titulo" => "Conflict of interests" ] 11 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2013-08-04" "fechaAceptado" => "2014-02-17" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec512377" "palabras" => array:5 [ 0 => "Fetus" 1 => "Congenital diaphragmatic hernia" 2 => "Magnetic resonance imaging" 3 => "Prenatal diagnosis" 4 => "Doppler ultrasonography" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec512376" "palabras" => array:5 [ 0 => "Feto" 1 => "Hernia diafragmática congénita" 2 => "Resonancia magnética" 3 => "Diagnóstico prenatal" 4 => "Ecografía Doppler" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "ObjectiveTo determine the usefulness of various parameters based on T2-weighted fetal magnetic resonance (MR) imaging measurements of the uninvolved lung for the neonatal prognosis of congenital diaphragmatic hernia (CDH). Materials and methodsWe used ultrasonography and MR imaging to study 28 fetuses with CDH. We retrospectively analyzed (a) on fetal ultrasonography, the observed-to-expected lung to head ratio (O/E LHR) and the position of the liver, and (b) on fetal MR imaging, the lung-liver signal ratio (LLSR) and the lungcerebrospinal fluid ratio (L/CSF SR). To determine the prognostic value of these parameters, we compared them with the following postnatal parameters: survival, pulmonary hypertension, need for oxygen supplementation, and need for extracorporeal membrane oxygenation. ResultsWe found significant differences between O/E LHR and the need for postnatal extracorporeal membrane oxygenation (p=.033) and postnatal survival (p=.01). We also found significant differences in LLSR between fetuses that survived more than 45 days and those that died within 45 days (1.91 vs 2.56; p=.039). ConclusionsIn fetuses with CDH, the LLSR correlates with postnatal survival and can potentially be used as a prognostic parameter in CDH." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Materials and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "ObjetivoDeterminar el pronóstico neonatal de la hernia diafragmática congénita (HDC) partiendo de la señal relativa del pulmón contralateral en secuencias rápidas T2 de resonancia magnética (RM) fetal. Material y métodosEstudiamos mediante ecografía y RM 28 fetos afectos de HDC y valoramos retrospectivamente en la ecografía fetal la relación entre el cociente observado y el esperado del diámetro axial máximo del pulmón dividido por el perímetro craneal (O/E LHR) y la posición hepática, y en la RM fetal el cociente de señal pulmón/hígado (LLSR) y el cociente de señal pulmón/líquido cefalorraquídeo (L/SF SR). Para determinar su valor pronóstico, los comparamos con los parámetros posnatales: supervivencia, hipertensión pulmonar, necesidad de oxígeno y la necesidad de oxigenación con membrana extracorpórea. ResultadosEncontramos diferencias significativas entre O/E LHR y la necesidad de oxigenación con membrana extracorpórea posnatal (p=0,033) y la supervivencia posnatal (p=0,01), y entre el LLSR de los fetos que sobrevivieron más de 45 días y los que no, con unas medianas de 1,91 y 2,56 respectivamente (p=0,039). ConclusionesEl LLSR se correlaciona con la supervivencia posnatal en fetos con HDC y puede potencialmente utilizarse como parámetro pronóstico de la HDC fetal." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivo" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Material y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] ] "NotaPie" => array:2 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Sebastià C, Gomez O, Salvador R, Buñesch L, Garcia R, Nicolau C. Cuantificación de la señal T2 pulmonar por resonancia magnética como factor pronóstico en las hernias diafragmáticas congénitas fetales. Radiología. 2015;57:239–247." ] 1 => array:2 [ "etiqueta" => "☆☆" "nota" => "This study has been possible thanks to a research grant from SERAM Industria 2009–2011." ] ] "multimedia" => array:8 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2100 "Ancho" => 2625 "Tamanyo" => 350458 ] ] "descripcion" => array:1 [ "en" => "T2-weighted axial image (HASTE). ROI for pulmonary (ROIs in the right hyperintense area) and hepatic measurements (ROIs in the left hypointense area)." ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 2100 "Ancho" => 2625 "Tamanyo" => 364211 ] ] "descripcion" => array:1 [ "en" => "T2-weighted sagittal image (HASTE). ROI for pulmonary and hepatic fetal measurements." ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 2600 "Ancho" => 3250 "Tamanyo" => 419821 ] ] "descripcion" => array:1 [ "en" => "T2-weighted axial image (HASTE). Measurements of signal intensity of the contralateral lung and the cephalo-rachidian liquid. Note the small size that the ROI needs to have to avoid errors due to partial volume of the bone marrow and the adjacent vertebra." ] ] 3 => array:7 [ "identificador" => "fig0020" "etiqueta" => "Figure 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 1041 "Ancho" => 1301 "Tamanyo" => 98521 ] ] "descripcion" => array:1 [ "en" => "T2-weighted sagittal image corresponding to the contralateral lung of one left congenital diaphragmatic hernia (arrow) of a 35-week old fetus with a lung to liver signal ratio (LLSR) of 3.7 and a lung to spinal fluid signal ratio (L/SF SR) of 0.87 with an excellent postnatal evolution." ] ] 4 => array:7 [ "identificador" => "fig0025" "etiqueta" => "Figure 5" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr5.jpeg" "Alto" => 1041 "Ancho" => 1301 "Tamanyo" => 96737 ] ] "descripcion" => array:1 [ "en" => "T2-weighted sagittal image corresponding to the contralateral lung of one left congenital diaphragmatic hernia (arrow) of a 27-week old fetus with a lung to liver signal ratio (LLSR) of 1.52 and a lung to spinal fluid signal ratio (L/SF SR) of 0.52. The mother refused intrauterine therapy and the fetus died due to respiratory failure at birth. The autopsy confirmed bilateral pulmonary hypoplasia. Note the difference of signal between <a class="elsevierStyleCrossRefs" href="#fig0020">Figs. 4 and 5</a>." ] ] 5 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "GA: gestational age measured in weeks, maternal age measured in years; L/SF SR: lung to spinal fluid signal ratio; CRL: cephalo-rachidian liquid; LLSR: lung to liver signal ratio; O/E LHR: observed-to-expected lung area to head circumference ratio." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Number of patients \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">28 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Maternal age \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">32.45 (22.81–38.87) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top">Race</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Caucasian \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">24 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Arab \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Asian \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Latin \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top">Side of hernia</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Right \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Left \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">23 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top">Ultrasound</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">EG \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">24.14 (20–35.43) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">LHR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.22 (0.52–2.99) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">O/E LHR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">41.92 (19.70–43.28) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top">Liver location</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Lower \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">17 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Upper \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">11 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top">Magnetic resonance</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">GA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">30.14 (25–32.43) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top">Liver location</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Lower \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">17 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Upper \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">11 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Lung signal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">177 (75.44–384.78) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">CRL signal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">280.89 (168.93–524.90) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Liver signal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">72.78 (32.06–174.67) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">LLSR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.4 (0.29–4.62) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">L/SF SR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.61 (0.28–0.89) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab779462.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Characteristics of the sample." ] ] 6 => array:7 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:3 [ "leyenda" => "ECMO: extracorporeal membrane oxygenation; L/SF SR: lung to spinal fluid signal ratio; LLSR: lung to liver signal ratio; O/E LHR: observed-to-expected lung area to head circumference ratio; US: ultrasound.Outcomes are expressed as a median [percentiles 25 and 75] and as (min, max) for quantitative variables and as the absolute frequency and percentage for qualitative variables." "tablatextoimagen" => array:4 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">ECMO \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">YesNo.=23 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">NoNo.=4 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p-Value \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top">US liver location</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Lower \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">13 (56.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3 (75%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.624<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Upper \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">10 (43.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 (25%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">US O/E LHR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">44.15 [33.97; 55.19] (19.7; 99.11) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">29.79 [25.19; 33.82] (23.43; 35) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.033 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">L/SF SR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.61 [0.53; 0.73] (0.42; 1.05) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.66 [0.55; 0.74] (0.45; 0.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.622 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">LLSR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2.4 [1.81; 3.19] (1.22; 4.48) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2.62 [2.15; 3.66] (2.01; 4.36) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.622 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab779461.png" ] ] 1 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Need for O2>30d \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">≤30No.=16 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">>30No.=4 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top">US liver location</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Lower \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">9 (56.2%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 (50%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Upper \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">7 (43.8%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 (50%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">US O/E LHR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">44.7 [34.35; 55.75] (23.43; 99.11) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">41.66 [30.38; 49.5] (26.95; 49.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.376 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">L/SF SR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.6 [0.54; 0.69] (0.43; 0.86) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.69 [0.53; 0.75] (0.42; 0.77) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.617 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">LLSR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2.32 [1.68; 3.24] (1.22; 4.48) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2.98 [2.64; 3.77] (2.51; 4.36) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.148 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab779464.png" ] ] 2 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Pulmonary hypertension \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">YesNo.=8 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">NoNo.=20 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top">US liver location</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Lower \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4 (50%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">13 (65%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.671<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Upper \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4 (50%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">7 (35%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">US O/ELHR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">44.7 [38.08; 55.75] (33.82; 56.62) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">40.42 [29.79; 49.5] (19.7; 99.11) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.299 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">L/SF SR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.61 [0.54; 0.74] (0.46; 0.86) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.61 [0.51; 0.7] (0.32; 1.05) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.709 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">LLSR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3.13 [2.14; 3.78] (1.81; 4.48) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2.37 [1.68; 2.79] (1.22; 4.36) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.11 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab779459.png" ] ] 3 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Survival at 45 days \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Dead (45d)No.=6 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Alive (45d)No.=22 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top">US liver location</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Lower \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3 (50%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">14 (63.6%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.653<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Upper \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3 (50%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">8 (36.4%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">US O/E LHR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">28.77 [21.94; 35] (19.7; 48.48) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">44.7 [34.73; 55.19] (23.43; 99.11) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.01 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">L/SF SR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.56 [0.45; 0.64] (0.32; 0.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.62 [0.55; 0.73] (0.42; 1.05) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.309 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">LLSR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.91 [1.52; 2.14] (1.22; 2.96) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2.56 [2.28; 3.41] (1.34; 4.48) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.039 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab779460.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "Absolute frequency ×." ] ] ] "descripcion" => array:1 [ "en" => "Results." ] ] 7 => array:7 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "CDH: congenital diaphragmatic hernia; L/SF SR: lung to spinal fluid signal ratio; CRL: cephalo-rachidian liquid; LLSR: lung to liver signal ratio; CAM: cystic adenomatoid malformation; p: patient; ROI: region of interest." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Author \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"># of CDH/total \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Assessment \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Outcomes \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Terui et al. (2011)<a class="elsevierStyleCrossRef" href="#bib0235">23</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">12 p CDH \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">L/SF SRAverage of signal of the two lungs measured in all cuts. ROI in LCR of 1–3mm2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Significant differences between survivors and neonatal deaths \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Cannie et al. (2011)<a class="elsevierStyleCrossRef" href="#bib0200">16</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">11 p CDH/105 without pulmonary alteration \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Average signal for each and every lung measured in all cuts with visible lung \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Significant differences between the pulmonary signal in normal fetuses and the ipsilateral lung to CDH no in the contralateral one \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Balassy et al. (2010)<a class="elsevierStyleCrossRef" href="#bib0180">12</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">25 p CDH/91 p controls \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">LLSR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">There were no significant differences between hernias with good and those with poor prognosis. Lungs with CDH were smaller and with a lower signal intensity than controlsAll fetuses with LLSR<2 did not survive \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Matsushita et al. (2008)<a class="elsevierStyleCrossRef" href="#bib0240">24</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">11 p/4 CAM \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">LLSRLung and liver ROI 1–3mm2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No significant differences between survivors and non-survivorsTrend>2 survival \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Nishie et al. (2009)<a class="elsevierStyleCrossRef" href="#bib0225">21</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">14 p \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">LLSR (median 3 lung ROI/3 liver ROI) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Significant differences between survivors and non-survivors with CDH \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Osada et al. (2004)<a class="elsevierStyleCrossRef" href="#bib0190">14</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">11 p/18 other conditions/58 healthy \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">L/SF SR. ROIs of the two lungs and CRL in the same cuts \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No significant differences between lungs with various conditions and normal lungsTrend<0.6 hypoplasia; >0.9 normal \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Keller et al. (2004)<a class="elsevierStyleCrossRef" href="#bib0230">22</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 p/5 p other conditions/35 healthy \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">LLSRBiggest possible lung and liver ROIs \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No significant differences between lungs with various conditions and normal lungs \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Kuwashima et al. (2001)<a class="elsevierStyleCrossRef" href="#bib0170">10</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 p/22 p other conditions \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">LLSRROI 1–3mm2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Significant differences between hypoplasic and normal lungsCutting value 2 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab779463.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Summary of bibliographic results." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:24 [ 0 => array:3 [ "identificador" => "bib0125" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Observed to expected lung area to head circumference ratio in the prediction of survival in fetuses with isolated diaphragmatic hernia" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Jani" 1 => "K.H. Nicolaides" 2 => "R.L. Keller" 3 => "A. Benachi" 4 => "C.F. Peralta" 5 => "R. Favre" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/uog.4052" "Revista" => array:6 [ "tituloSerie" => "Ultrasound Obstet Gynecol" "fecha" => "2007" "volumen" => "30" "paginaInicial" => "67" "paginaFinal" => "71" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17587219" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0130" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Association between intrapulmonary arterial Doppler parameters and degree of lung growth as measured by lung-to-head ratio in fetuses with congenital diaphragmatic hernia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "O. Moreno-Alvarez" 1 => "E. Hernandez-Andrade" 2 => "D. Oros" 3 => "J. Jani" 4 => "J. Deprest" 5 => "E. Gratacos" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/uog.5201" "Revista" => array:6 [ "tituloSerie" => "Ultrasound Obstet Gynecol" "fecha" => "2008" "volumen" => "31" "paginaInicial" => "164" "paginaFinal" => "170" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18196498" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0135" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Lung tissue perfusion in congenital diaphragmatic hernia and association with the lung-to head ratio an intrapulmonary artery pulsed Doppler" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "O. Moreno-Alvarez" 1 => "R. Cruz-Martinez" 2 => "E. Hernandez-Andrade" 3 => "E. Done" 4 => "O. Gomez" 5 => "J. Deprest" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/uog.7592" "Revista" => array:6 [ "tituloSerie" => "Ultrasound Obstet Gynecol" "fecha" => "2010" "volumen" => "35" "paginaInicial" => "578" "paginaFinal" => "582" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20178113" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0140" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The correlation between lung volume and liver herniation measurements by fetal MRI in isolated diaphragmatic hernia: a systematic review and meta-analysis of observational studies" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Mayer" 1 => "P. Klaritsh" 2 => "S. Peersen" 3 => "E. Done" 4 => "I. Sandaite" 5 => "F. Claus" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/pd.2839" "Revista" => array:6 [ "tituloSerie" => "Prenat Diagn" "fecha" => "2011" "volumen" => "31" "paginaInicial" => "1086" "paginaFinal" => "1096" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21915885" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0145" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Re-evaluation of stomach position as a simple prognostic factor in fetal left congenital diaphragmatic hernia: a multicenter survey in Japan" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "Y. Kitano" 1 => "H. Okuyama" 2 => "M. Saito" 3 => "N. Usui" 4 => "N. Morikaa" 5 => "K. Masumoto" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/uog.8892" "Revista" => array:6 [ "tituloSerie" => "Ultrasound Obstet Gynecol" "fecha" => "2011" "volumen" => "37" "paginaInicial" => "277" "paginaFinal" => "282" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21337653" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0150" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Fetal magnetic resonance imaging evaluation of congenital diaphragmatic hernia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "C. Sebastià" 1 => "R. Garcia" 2 => "O. Gomez" 3 => "B. Paño" 4 => "C. Nicolau" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:2 [ "tituloSerie" => "Radiologia" "fecha" => "2013" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0155" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Diffusion-weighted MRI in lungs of normal fetuses and those with congenital diaphragmatic hernia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M. Cannie" 1 => "J. Jani" 2 => "F. de Keyzer" 3 => "I. Roebben" 4 => "S. Dymarkowski" 5 => "J. Deprest" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/uog.7326" "Revista" => array:6 [ "tituloSerie" => "Ultrasound Obstet Gynecol" "fecha" => "2009" "volumen" => "34" "paginaInicial" => "678" "paginaFinal" => "686" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19866446" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0160" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Performance of an automatic quantitative ultrasound analysis of the fetal lung to predict fetal lung maturity" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Palacio" 1 => "T. Cobo" 2 => "M. Martinez-Terrón" 3 => "G.A. Rattá" 4 => "E. Bonet-Carné" 5 => "I. Amat-Roldan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ajog.2012.09.027" "Revista" => array:6 [ "tituloSerie" => "Am J Obstet Gynecol" "fecha" => "2012" "volumen" => "207" "paginaInicial" => "504.e1" "paginaFinal" => "504.e5" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23174391" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0165" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "In vivo 1(H) magnetic resonance spectroscopy of amniotic fluid and fetal lung at 1.5T: technical challenges" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "D. Kim" 1 => "K. Vahidi" 2 => "A.B. Caughey" 3 => "F.V. Coakley" 4 => "D.B. Vigneron" 5 => "J. Kurhanewicz" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/jmri.21528" "Revista" => array:6 [ "tituloSerie" => "J Magn Reson Imaging" "fecha" => "2008" "volumen" => "28" "paginaInicial" => "1033" "paginaFinal" => "1038" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18821604" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0170" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Low-intensity fetal lungs on MRI may suggest the diagnosis of pulmonary hypoplasia" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Kuwashima" 1 => "Nishimura" 2 => "F. Iimura" 3 => "T. Kohno" 4 => "Watanabe h" 5 => "A. Kohno" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s002470100512" "Revista" => array:6 [ "tituloSerie" => "Pediatr Radiol" "fecha" => "2001" "volumen" => "31" "paginaInicial" => "669" "paginaFinal" => "672" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11512012" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0175" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Fetal lung-to-liver signal intensity ratio at MR imaging: development of a normal scale and possible role in predicting pulmonary hypoplasia in utero" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "L.J. Brewerton" 1 => "R.S. Chari" 2 => "Y. Liang" 3 => "R. Bhargava" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Radiology" "fecha" => "2005" "volumen" => "253" "paginaInicial" => "1005" "paginaFinal" => "1010" ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0180" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Assessment of lung development in isolated congenital diaphragmatic hernia using signal intensity ratios on fetal MR imaging" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C. Balassy" 1 => "G. Kasprian" 2 => "P.C. Brugger" 3 => "M. Weber" 4 => "B. Csapo" 5 => "C. Herold" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00330-009-1633-x" "Revista" => array:6 [ "tituloSerie" => "Eur Radiol" "fecha" => "2010" "volumen" => "20" "paginaInicial" => "829" "paginaFinal" => "837" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19890648" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0185" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prediction of outcome in isolated congenital diaphragmatic hernia and its consequences for fetal therapy" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "L. Gucciardo" 1 => "J. Deprest" 2 => "E. Done’" 3 => "T. van Mieghem" 4 => "M. van de Velde" 5 => "E. Gratacos" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.bpobgyn.2007.08.006" "Revista" => array:6 [ "tituloSerie" => "Best Pract Res Clin Obstet Gynaecol" "fecha" => "2008" "volumen" => "22" "paginaInicial" => "123" "paginaFinal" => "138" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18082455" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0190" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Quantitative and qualitative evaluations of fetal lung with MR imaging" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "H. Osada" 1 => "K. Kahu" 2 => "K. Masuda" 3 => "Y. Litsuda" 4 => "K. Seki" 5 => "S. Sekiya" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1148/radiol.2313021689" "Revista" => array:6 [ "tituloSerie" => "Radiology" "fecha" => "2004" "volumen" => "231" "paginaInicial" => "887" "paginaFinal" => "892" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15118120" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0195" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "T2 quantifications of lungs in the fetal lamb with experimentally-induced congenital diaphragmatic hernia" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "L. Breysem" 1 => "H. Bosmans" 2 => "J. Jani" 3 => "X. Roubliova" 4 => "M. Cannie" 5 => "J. Deprest" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1159/000097115" "Revista" => array:6 [ "tituloSerie" => "Fetal Diagn Ther" "fecha" => "2007" "volumen" => "22" "paginaInicial" => "143" "paginaFinal" => "148" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17139173" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0200" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "T2 quantifications of fetal lungs at MRI-normal ranges" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M. Cannie" 1 => "J. Jani" 2 => "F. de Keyzer" 3 => "I. Roebben" 4 => "L. Breysem" 5 => "J. Deprest" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/pd.2746" "Revista" => array:6 [ "tituloSerie" => "Prenat Diagn" "fecha" => "2011" "volumen" => "31" "paginaInicial" => "705" "paginaFinal" => "711" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21425299" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0205" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pulmonary acinar development in diaphragmatic hernia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "Y. Nakamura" 1 => "I. Yamamoto" 2 => "S. Fukuda" 3 => "T. Hashimoto" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Pathol Lab Med" "fecha" => "1991" "volumen" => "115" "paginaInicial" => "372" "paginaFinal" => "376" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2012498" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0210" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Lung maturation in neonatal respiratory disorders" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "A. Greenough" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:4 [ "titulo" => "Pediatric respiratory disease" "paginaInicial" => "13" "paginaFinal" => "26" "serieFecha" => "2006" ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0215" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "MRI of normal and pathological fetal lung development" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "G. Kasprian" 1 => "C. Balassy" 2 => "P.C. Brugger" 3 => "D. Prayer" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ejrad.2005.11.031" "Revista" => array:6 [ "tituloSerie" => "Eur J Radiol" "fecha" => "2006" "volumen" => "57" "paginaInicial" => "261" "paginaFinal" => "270" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16413987" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0220" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Demonstration of changes in fetal liver erythropoiesis using echo-planar magnetic resonance imaging" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "K.R. Duncan" 1 => "P.N. Baker" 2 => "P.A. Gowland" 3 => "B. Issa" 4 => "R. Moore" 5 => "B. Worthington" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Am J Physiol" "fecha" => "1997" "volumen" => "273" "paginaInicial" => "G965" "paginaFinal" => "G967" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9357842" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0225" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "MR prediction of postnatal outcomes in felt-sided congenital diaphragmatic hernia using right lung signal intensity: comparison with that using right lung volume" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Nishie" 1 => "T. Tajima" 2 => "Y. Asayama" 3 => "K. Ishigami" 4 => "M. Hirakawa" 5 => "T. Nakayama" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/jmri.21829" "Revista" => array:6 [ "tituloSerie" => "J Magn Reson Imaging" "fecha" => "2009" "volumen" => "30" "paginaInicial" => "112" "paginaFinal" => "120" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19557726" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0230" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "MR assessment of fetal lung development using lung volumes and signal intensities" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "T.M. Keller" 1 => "A. Rake" 2 => "S.C.S. Michel" 3 => "B. Seifert" 4 => "J. Wisser" 5 => "B. Marincek" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00330-004-2256-x" "Revista" => array:6 [ "tituloSerie" => "Eur Radiol" "fecha" => "2004" "volumen" => "14" "paginaInicial" => "984" "paginaFinal" => "989" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15014973" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0235" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prediction of postnatal outcomes in congenital diaphragmatic hernia using MRI signal intensity of the fetal lung" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "K. Terui" 1 => "A. Omoto" 2 => "T. Hishiki" 3 => "T. Saito" 4 => "Y. Sato" 5 => "M. Nakata" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1038/jp.2010.119" "Revista" => array:6 [ "tituloSerie" => "J Perinatol" "fecha" => "2011" "volumen" => "31" "paginaInicial" => "269" "paginaFinal" => "273" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21052047" "web" => "Medline" ] ] ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0240" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "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" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Matsushita" 1 => "K. Ishii" 2 => "M. Tamura" 3 => "Y. Takahashi" 4 => "T. Kamura" 5 => "K. Takakuwa" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1447-0756.2008.00754.x" "Revista" => array:5 [ "tituloSerie" => "J Obstet Gynaecol Res" "fecha" => "2008" "volumen" => "34" "paginaInicial" => "162" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18412776" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735107/0000005700000003/v2_201504291245/S2173510715000257/v2_201504291245/en/main.assets" "Apartado" => array:4 [ "identificador" => "8098" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Original reports" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735107/0000005700000003/v2_201504291245/S2173510715000257/v2_201504291245/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173510715000257?idApp=UINPBA00004N"]

Statistics

Original Report

Cuantificación de la señal T2 pulmonar por resonancia magnética como factor pronóstico en las hernias diafragmáticas congénitas fetales

C. Sebastiàa,

Corresponding author

msebasti@clinic.ub.es

Corresponding author.

, O. Gomezb, R. Salvadora, L. Buñescha, R. Garciab, C. Nicolaua

a Departamento de Radiología (CDI), Hospital Clínic, Barcelona, Spain

b Departamento de Ginecología y Obstetricia (ICGON), Hospital Clínic, Barcelona, Spain

Read

879

Times
was read the article

279

Total PDF

600

Total HTML

Share statistics

 array:22 [
  "pii" => "S2173510715000257"
  "issn" => "21735107"
  "doi" => "10.1016/j.rxeng.2014.02.006"
  "estado" => "S300"
  "fechaPublicacion" => "2015-05-01"
  "aid" => "728"
  "copyright" => "SERAM"
  "copyrightAnyo" => "2013"
  "documento" => "article"
  "subdocumento" => "fla"
  "cita" => "Radiologia. 2015;57:239-47"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:2 [
    "total" => 868
    "formatos" => array:2 [
      "HTML" => 589
      "PDF" => 279
    ]
  ]
  "Traduccion" => array:1 [
    "es" => array:19 [
      "pii" => "S0033833814000344"
      "issn" => "00338338"
      "doi" => "10.1016/j.rx.2014.02.001"
      "estado" => "S300"
      "fechaPublicacion" => "2015-05-01"
      "aid" => "728"
      "copyright" => "SERAM"
      "documento" => "article"
      "crossmark" => 1
      "subdocumento" => "fla"
      "cita" => "Radiologia. 2015;57:239-47"
      "abierto" => array:3 [
        "ES" => false
        "ES2" => false
        "LATM" => false
      ]
      "gratuito" => false
      "lecturas" => array:2 [
        "total" => 1331
        "formatos" => array:3 [
          "EPUB" => 18
          "HTML" => 877
          "PDF" => 436
        ]
      ]
      "es" => array:13 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Original</span>"
        "titulo" => "Cuantificaci&#243;n de la se&#241;al T2 pulmonar por resonancia magn&#233;tica como factor pron&#243;stico en las hernias diafragm&#225;ticas cong&#233;nitas fetales"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "tieneResumen" => array:2 [
          0 => "es"
          1 => "en"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "239"
            "paginaFinal" => "247"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Prognostic usefulness of derived T2-weighted fetal magnetic resonance imaging measurements in congenital diaphragmatic hernia"
          ]
        ]
        "contieneResumen" => array:2 [
          "es" => true
          "en" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0020"
            "etiqueta" => "Figura 4"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr4.jpeg"
                "Alto" => 1124
                "Ancho" => 1405
                "Tamanyo" => 91912
              ]
            ]
            "descripcion" => array:1 [
              "es" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Imagen sagital en T2 que corresponde al pulm&#243;n contralateral a una hernia diafragm&#225;tica cong&#233;nita izquierda &#40;flecha&#41; de un feto de 35 semanas con un cociente de intensidad de se&#241;al pulm&#243;n-h&#237;gado &#40;LLSR&#41; de 3&#44;7 y un cociente de intensidad de se&#241;al pulm&#243;n-l&#237;quido cefalorraqu&#237;deo &#40;L&#47;SF SR&#41; de 0&#44;87&#44; con excelente evoluci&#243;n posnatal&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "C&#46; Sebasti&#224;, O&#46; Gomez, R&#46; Salvador, L&#46; Bu&#241;esch, R&#46; Garcia, C&#46; Nicolau"
            "autores" => array:6 [
              0 => array:2 [
                "nombre" => "C&#46;"
                "apellidos" => "Sebasti&#224;"
              ]
              1 => array:2 [
                "nombre" => "O&#46;"
                "apellidos" => "Gomez"
              ]
              2 => array:2 [
                "nombre" => "R&#46;"
                "apellidos" => "Salvador"
              ]
              3 => array:2 [
                "nombre" => "L&#46;"
                "apellidos" => "Bu&#241;esch"
              ]
              4 => array:2 [
                "nombre" => "R&#46;"
                "apellidos" => "Garcia"
              ]
              5 => array:2 [
                "nombre" => "C&#46;"
                "apellidos" => "Nicolau"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S2173510715000257"
          "doi" => "10.1016/j.rxeng.2014.02.006"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => false
            "ES2" => false
            "LATM" => false
          ]
          "gratuito" => false
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173510715000257?idApp=UINPBA00004N"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0033833814000344?idApp=UINPBA00004N"
      "url" => "/00338338/0000005700000003/v2_201504220437/S0033833814000344/v2_201504220437/es/main.assets"
    ]
  ]
  "itemAnterior" => array:18 [
    "pii" => "S2173510715000269"
    "issn" => "21735107"
    "doi" => "10.1016/j.rxeng.2014.01.001"
    "estado" => "S300"
    "fechaPublicacion" => "2015-05-01"
    "aid" => "729"
    "copyright" => "SERAM"
    "documento" => "article"
    "subdocumento" => "fla"
    "cita" => "Radiologia. 2015;57:229-38"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 830
      "formatos" => array:2 [
        "HTML" => 595
        "PDF" => 235
      ]
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original Report</span>"
      "titulo" => "Is the performance of MRI in preoperative staging of breast cancer independent of clinical and histological factors&#63; A subgroup analysis"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "229"
          "paginaFinal" => "238"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "El rendimiento de la RM en la estadificaci&#243;n preoperatoria del carcinoma de mama ser&#237;a independiente de factores cl&#237;nicos y patol&#243;gicos&#58; an&#225;lisis de subgrupos"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0010"
          "etiqueta" => "Figure 2"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr2.jpeg"
              "Alto" => 1419
              "Ancho" => 1000
              "Tamanyo" => 185425
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Multifocal infiltrating ductal carcinoma&#46; Main lesion &#40;white arrow&#41; with multiple satellite foci&#46; Focus at more than 1<span class="elsevierStyleHsp" style=""></span>cm of the main one &#40;arrowhead&#41; &#40;a&#41;&#46; Infiltrating ductal carcinoma &#40;arrow&#41;&#44; asymmetrical enhancement of the nipple and subareolar region &#40;arrow&#41;&#46; The multicentric lesion was confirmed in the ultrasound-guided biopsy &#40;b&#41;&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "C&#46; Carreira G&#243;mez, J&#46; Zamora Romero, A&#46; Gil de Miguel, M&#46; Chiva de Agust&#237;n, M&#46;N&#46; Plana Farr&#225;s, J&#46; Mart&#237;nez Gonz&#225;lez"
          "autores" => array:6 [
            0 => array:2 [
              "nombre" => "C&#46;"
              "apellidos" => "Carreira G&#243;mez"
            ]
            1 => array:2 [
              "nombre" => "J&#46;"
              "apellidos" => "Zamora Romero"
            ]
            2 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "Gil de Miguel"
            ]
            3 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Chiva de Agust&#237;n"
            ]
            4 => array:2 [
              "nombre" => "M&#46;N&#46;"
              "apellidos" => "Plana Farr&#225;s"
            ]
            5 => array:2 [
              "nombre" => "J&#46;"
              "apellidos" => "Mart&#237;nez Gonz&#225;lez"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0033833814000356"
        "doi" => "10.1016/j.rx.2014.01.002"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0033833814000356?idApp=UINPBA00004N"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173510715000269?idApp=UINPBA00004N"
    "url" => "/21735107/0000005700000003/v2_201504291245/S2173510715000269/v2_201504291245/en/main.assets"
  ]
  "en" => array:20 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Original Report</span>"
    "titulo" => "Prognostic usefulness of derived T2-weighted fetal magnetic resonance imaging measurements in congenital diaphragmatic hernia"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "239"
        "paginaFinal" => "247"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "C&#46; Sebasti&#224;, O&#46; Gomez, R&#46; Salvador, L&#46; Bu&#241;esch, R&#46; Garcia, C&#46; Nicolau"
        "autores" => array:6 [
          0 => array:4 [
            "nombre" => "C&#46;"
            "apellidos" => "Sebasti&#224;"
            "email" => array:1 [
              0 => "msebasti&#64;clinic&#46;ub&#46;es"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "O&#46;"
            "apellidos" => "Gomez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "R&#46;"
            "apellidos" => "Salvador"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "L&#46;"
            "apellidos" => "Bu&#241;esch"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "R&#46;"
            "apellidos" => "Garcia"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "C&#46;"
            "apellidos" => "Nicolau"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:2 [
          0 => array:3 [
            "entidad" => "Departamento de Radiolog&#237;a &#40;CDI&#41;&#44; Hospital Cl&#237;nic&#44; Barcelona&#44; Spain"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Departamento de Ginecolog&#237;a y Obstetricia &#40;ICGON&#41;&#44; Hospital Cl&#237;nic&#44; Barcelona&#44; Spain"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Cuantificaci&#243;n de la se&#241;al T2 pulmonar por resonancia magn&#233;tica como factor pron&#243;stico en las hernias diafragm&#225;ticas cong&#233;nitas fetales"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0020"
        "etiqueta" => "Figure 4"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr4.jpeg"
            "Alto" => 1041
            "Ancho" => 1301
            "Tamanyo" => 98521
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">T2-weighted sagittal image corresponding to the contralateral lung of one left congenital diaphragmatic hernia &#40;arrow&#41; of a 35-week old fetus with a lung to liver signal ratio &#40;LLSR&#41; of 3&#46;7 and a lung to spinal fluid signal ratio &#40;L&#47;SF SR&#41; of 0&#46;87 with an excellent postnatal evolution&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">The right growth and maturation of fetal lungs are key in the post-natal period&#46; The processes compressing the chest cavity such as the congenital diaphragmatic hernia &#40;CDH&#41; and the oligohidramnios can affect the development of fetal lungs leading the pulmonary hypoplasis and secondary pulmonary hypertesions&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">1</span></a> The fetal pulmonary evaluation in fetuses with CDH is usually done through ultrasound even though recently the utility of magnetic resonance imaging &#40;MRI&#41;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">1</span></a> has been confirmed&#46; The most valued ultrasound prognostic indicator for the assessment of pulmonary development is the ratio between the observed value and the observed-to-expected lung area to head circumference ratio O&#47;E LHR&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">1</span></a> Also the Doppler echographic parameters of the pulmonary artery and pulmonary perfusion can be studied which will tell us&#44; respectively&#44; if there is pulmonary hypertension and how the intrapulmonary vascularization really is&#8211;indirect signs of pulmonary hypoplasia&#46;<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">2&#44;3</span></a> The location of the liver in the thorax&#8211;inside the CDH is an independent sign of poor neonatal prognosis correlated with the degree of hypoplasia&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">1</span></a> These data can be assessed echographically yet it is recommended to study it through MRIs since the liver is better differentiated from other organs and adjacent structures that are similar echographically&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">4</span></a> There are other MRI parameters that can help us study pulmonary hyperplasia&#44; while most of them are based on the volume like the homo and&#47;or contralateral relative pulmonary volume&#44; the percentage of herniated liver or the gastric location of the hernia&#8211;all of them indirectly reporting about pulmonary compression due to the mass effect of hernia&#46;<a class="elsevierStyleCrossRefs" href="#bib0140"><span class="elsevierStyleSup">4&#8211;6</span></a> Recently other parameters of fetal pulmonary imaging providing qualitative data of pulmonary maturation have been reported like the relative pulmonary signal in T2 and T2-weighted MRIs&#44; diffusion-weighted and spectroscopic MRIs or ultrasound-based images on pulmonary texture&#8211;useful to distinguish normal from hypoplasic lungs&#46;<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">7&#8211;9</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The goal of this study is to determine the neonatal prognosis of CDH from the contralateral lung relative signal in T2-weighted fast sequences of fetal MRIs&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Materials and methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Patients</span><p id="par0015" class="elsevierStylePara elsevierViewall">From January 2006 to December 2011&#44; 79 pregnant women with fetuses echographically diagnosed with CDH were seen in our center&#46; All of them were studied through fetal ultrasound and MRI as part of the study protocol for CDH&#46; The sample consisted of patients from the very hospital care units and patients from other hospitals sent to our center&#46; Among them&#44; 50 met the criteria for fetal endoscopic tracheal occlusion of which 43 underwent surgery and were excluded from the study while in the remaining seven the pregnancy was interrupted&#46; The 29 patients who did not receive any therapies went on with their pregnancies and they made up the study sample&#46; In all patients delivery took place in our center except for four cases that due to their good prenatal prognosis were referred to their corresponding centers of reference&#46; One case was eliminated from the study due to lack of postnatal data&#46; The final number of patients included in the study was therefore 28 whose characteristics can be seen in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46; No fetus showed other congenital or chromosomic malformations&#46; This work is a part of a wider investigational protocol approved by our hospital ethical committee&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Image modalities</span><p id="par0020" class="elsevierStylePara elsevierViewall">The ultrasounds were obtained through the Siemens Sonoline Antares &#40;Siemens Medical Systems&#44; Malvern&#44; PA&#44; USA&#41; or Voluson 730 Expert ultrasound scanners &#40;GE Medical Systems&#44; Milwaukee&#44; WI&#44; USA&#41; following the usual technique&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">1</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">The MRIs were acquired through a 1&#46;5 Tesla machine &#40;Magneton Symphony&#44; Siemens Medical Systems&#44; Erlangen&#44; Germany&#41; using a 6-channel coil&#46; The patient was placed in the decubitus supine position always under sedation&#46; The patient never received corticoids before the MRI&#46; The T2-weighted sequences were obtained through a half-Fourier acquisition single-shot turbo spin-echo &#40;HASTE&#41; sequence in the axial&#44; coronal and sagittal planes orthogonal to the fetus of 5<span class="elsevierStyleHsp" style=""></span>mm thickness without overlapping&#44; FOV 380<span class="elsevierStyleHsp" style=""></span>mm<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>380<span class="elsevierStyleHsp" style=""></span>mm&#44; matrix 173<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>256&#44; TR&#47;TE<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;000&#47;88<span class="elsevierStyleHsp" style=""></span>ms&#44; a partial Fourier factor of 5&#47;8 for a pixel resolution of 2&#46;2<span class="elsevierStyleHsp" style=""></span>mm<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>1&#46;5<span class="elsevierStyleHsp" style=""></span>mm<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>4<span class="elsevierStyleHsp" style=""></span>mm&#44; and a 475<span class="elsevierStyleHsp" style=""></span>Hz&#47;pixel bandwidth&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">The echographic data were collected retrospectively from the fetal ultrasound report &#40;O&#47;E LHR and hepatic location&#41; and one 5-year experienced radiologist in fetal MRIs who did not know about the postnatal evolution of fetuses evaluated hepatic location and drew the regions of interest &#40;ROI&#41; in lung&#44; liver&#44; and cephalo-rachidian liquid &#40;CRL&#41; in the T2-weighted sequences&#46; For the assessment of the contralateral pulmonary signal we followed the most popular method described in literature by Kuwasima and then reproduced by Brewerton and Balassy&#46;<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">10&#8211;12</span></a> Three measurements of the lung contralateral to the hernia while avoiding vessels and bronchi were taken with an ROI between 0&#46;5 and 2<span class="elsevierStyleHsp" style=""></span>mm<span class="elsevierStyleSup">2</span>&#44; and three ROIs in the liver also avoiding the hepatic vessels of between 1&#46;5 and 3<span class="elsevierStyleHsp" style=""></span>mm<span class="elsevierStyleSup">2</span>&#46; The pulmonary and liver measurements were taken in the same cut in one axial or sagittal image choosing both the plane and image with the least possible artifacts&#46; The average of the three pulmonary measurements divided by the average of the three hepatic measurements is called the LLSR &#40;lung to liver signal ratio&#41; &#40;<a class="elsevierStyleCrossRefs" href="#fig0005">Figs&#46; 1 and 2</a>&#41;&#46; For the measurement of the CRL signal the axial plane was used in which no artifacts were seen while measuring the lung as described before and also drawing three ROIs in the CRL while avoiding the bone marrow and proximal bones of between 0&#46;1 and 1<span class="elsevierStyleHsp" style=""></span>mm<span class="elsevierStyleSup">2</span> &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#41;&#46; The average of the three pulmonary measurements divided by the average of the three CRL measurements is called the L&#47;SF SR &#40;lung to spinal fluid signal ratio&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">We studied the correlation between the echographic prenatal parameters &#40;liver located above or under the diaphragm and O&#47;E LHR&#41; and the MRI-based echographic prenatal parameters &#40;LLSR and L&#47;SF SR&#41; and the existence&#8211;or not of pulmonary hypertension assessed through echocardiography&#44; also the postnatal survival &#40;death before or after the first 45 days from delivery attributable to CDH&#41;&#44; the need for oxygen &#40;&#62; or &#60;30 days&#41;&#44; and the need&#8211;or not for extracorporeal membrane oxygenation &#40;ECMO&#41; &#40;<a class="elsevierStyleCrossRefs" href="#fig0020">Figs&#46; 4 and 5</a>&#41;&#46;</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia><elsevierMultimedia ident="fig0025"></elsevierMultimedia></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Statistical analysis</span><p id="par0040" class="elsevierStylePara elsevierViewall">The quantitative variables were described as maximum&#44; minimum&#44; median and interquartile ranges and compared with the non-parametric Mann&#8211;Whitney <span class="elsevierStyleItalic">U</span> test&#46; The quantitative variables were described as absolute and relative frequencies and analyzed through the Fischer&#39;s exact test&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">To obtain a cutting point of variables LLSR and L&#47;SF SR the positive coefficient of probability &#40;CP&#43;&#41; for mortality was assessed and defined as the ratio sensitivity&#47;&#40;1<span class="elsevierStyleHsp" style=""></span>&#8722;<span class="elsevierStyleHsp" style=""></span>especificity&#41;&#46; Compared with an ROC analysis the value of CP&#43; in this study allows us to quantify the goodness of the cutting point proposed because the ratio of CP&#43; also expresses the relation of true positives vs false negatives for a determined cutting point&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">The statistical analysis was performed through the SPSS 20 software &#40;IBM&#41; using a type I error rate of 5&#37; bilateral&#46; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05 was considered significant&#46;</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Results</span><p id="par0055" class="elsevierStylePara elsevierViewall">In the 28 cases we had the O&#47;E LHR and the ultrasound-based hepatic location and the measurements of the contralateral&#44; hepatic pulmonary signal and that of the CRL&#46; In summary&#44; the results can be seen in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#46; In 27 out of 28 cases we had information on the need&#8211;or not for ECMO&#46; In one case in which delivery happened outside the hospital we did not have the corresponding information so the total number of cases in which we compared the radiologic findings with the need for ECMO was 27&#46; In 20 of the 28 cases we knew exactly the number of days during which the newly born baby needed oxygen&#46; In the 28 cases we could assess postnatal survival and the diagnosis of pulmonary hypertension&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">Among all of the assessed data only the relation between O&#47;E LHR and the need for postnatal ECMO &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;033&#41; and between O&#47;E LHR and LLSR and postnatal survival &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;01 and <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;039&#44; respectively&#41; were statistically significant&#46; There was no significant relation between the hepatic location or the L&#47;SF SR with any of the postnatal parameters&#46; Neither between the LLSR and the need for oxygen&#44; ECMO or pulmonary hypertension&#46; The LLSR cutting point between survivors and non-survivors was 2&#46;2 with a CP&#43;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#46;7&#59; and 0&#46;52 for L&#47;SF SR&#44; with a CP&#43;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#46;7&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Discussion</span><p id="par0065" class="elsevierStylePara elsevierViewall">In our study we proved that even though the most consistent parameter to predict postnatal prognosis like several studies ratify<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">1&#44;6</span></a> is the echographic O&#47;E LHR there is also a statistically significant relation between the highest values of LLSR and the postnatal survival beyond 45 days&#46; Assessing the degree of pulmonary hypoplasia in fetuses with CDH is very important for prenatal advice and to predict postnatal evolution&#46; One-third of the newly born babies with CDH will die from pulmonary hyperplasia and&#47;or pulmonary hypertension&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">13</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">Being able to diagnose correctly prenatal pulmonary hypoplasia with image modalities is still a challenge&#46; Today the ultrasound-assessed O&#47;E LHR is considered to be the most consistently correlated parameter with the postnatal prognosis in fetuses with CDH&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">1</span></a> MRIs allow us to study the chemical and structural characteristics of several tissues&#46; Studies published on animal and human experimentation have analyzed the relation between the signal intensity and the pulmonary structure&#46;<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">13&#8211;16</span></a> There is a significant positive correlation between the T2-weighted signal of healthy lungs and gestational age and there are no significant differences between the signal of the two lungs in healthy fetuses&#46; Different formulae have been proposed to be able to calculate the pulmonary signal intensity in healthy fetuses based on gestational age&#46;<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">13&#44;14&#44;16</span></a></p><p id="par0075" class="elsevierStylePara elsevierViewall">Pulmonary hypoplasia is defined anatomopathologically as the shrinking of airways and the number of alveoli with respect to a normal lung&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">17</span></a> Even though the pathogenesis is not clear yet the pulmonary liquid can have an important role in pulmonary development&#46; Lungs with a significant hyperintensity in the T2-weighted sequences are normal while those highly hypointense are hypoplasic while a cutting value for LLSR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2 can help us distinguish hypoplasic from normal lungs&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">10</span></a> This statement is only valid from the gestational week &#35;26&#8211;not earlier because the production of liquid in the fetus lungs starts in the second quarter when the pulmonary interstitium refines gradually&#46;<a class="elsevierStyleCrossRefs" href="#bib0160"><span class="elsevierStyleSup">8&#44;11</span></a> All these have to do with the anatomic studies that consider that the pulmonary development and maturation in the canalicular and alveolar phases are similar in normal and hypoplasic lungs&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">18</span></a> On the other hand&#44; the pulmonary signal of lungs compressed due to CDH is very similar to that of the contralateral lung suggesting that the hernia contralateral signal can be a good marker of global pulmonary signal&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">19</span></a></p><p id="par0080" class="elsevierStylePara elsevierViewall">MRI-based signal intensity of any tissues depends on the sequence used and the distance to the coil&#8211;this is why absolute values are not appropriate to assess this&#46; This is why structures at a similar depth are used as a reference&#46; These structures can be the liver&#44; the CRL and the amniotic fluid&#46; To be able to estimate the ratio between the intensity of pulmonary signal and that of a reference structure this second structure should not experience changes with gestational age&#46; The liver signal changes based on pregnancy probably due to the progressive increase of the concentrations of iron and the progressive reduction in the production of hemoglobin<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">20</span></a> and can be an excellent parameter of reference&#46; Yet these differences were studied in the 20 and 26th weeks of pregnancy not later&#46; The CRL however does not experience any changes during pregnancy&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">14</span></a></p><p id="par0085" class="elsevierStylePara elsevierViewall">There are very few studies showing the efficacy of measuring the T2-weighted pulmonary signal intensity in fetuses with CDH and its relation to pulmonary hypoplasia and the fetal postnatal prognosis and all of them are based in very few cases and use different methods &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46; Even though it is well known that the hepatic signal varies with gestational age before the 25th week of pregnancy most studies support the LLSR&#44;<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">9&#44;11&#44;12&#44;21&#44;22</span></a> while other studies have valued the L&#47;SF SR<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">14&#8211;23</span></a> with contradictory results&#46; Even though no significant differences between the L&#47;SF SR of newly born babies with good or poor prognosis have been found in our study&#44; there is a trend that patients with poor prognosis have a lower ratio with an average signal in these cases similar to that of previous studies of around 0&#46;65&#46; Similarly the differences among patients with good or poor prognosis and the LLSR cutting level are also similar to that of previous studies &#40;around 2&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0160"><span class="elsevierStyleSup">8&#44;24</span></a></p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall">Our study has some limitations&#46; It is a retrospective study with a small sample yet it needs to be reminded that it is an uncommon process and that our series is the largest one ever published&#46; Another limitation of this study is that the measurement of signal intensity was taken by one radiologist only and we did not calculate the variability induced by the observer&#46; Also in daily routine it is hard to draw one relatively big ROI in the CRL without including the bone marrow or the adjacent vertebra&#46; The possible error of measurement can be the reason for the lack of conclusive results in our study with L&#47;SF SR&#46; Also the signal intensity among images and sequences has been extremely variable&#46; However measurement variability is solved by estimating the ratio&#46; A third limitation is that our sample is biased because mid-and-high risk patients who met the criteria for fetal endoscopic tracheal occlusion underwent surgery and we only have the natural evolution of those fetuses that were not candidates to undergo fetal endoscopic tracheal occlusion or mothers who refused this therapy and moved on with their pregnancy&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">In summary&#44; our study shows that the LLSR is a parameter correlated with postnatal survival in fetuses with CDH that potentially can be used as a prognostic parameter in the fetal study of CDH&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Ethical responsibilities</span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Protection of people and animals</span><p id="par0100" class="elsevierStylePara elsevierViewall">Authors confirm that no experiments have been performed on human beings or animals&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Data confidentiality</span><p id="par0105" class="elsevierStylePara elsevierViewall">Authors confirm that the protocols of their institution have been followed on the publication of data from patients&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Right to privacy and informed consent</span><p id="par0110" class="elsevierStylePara elsevierViewall">Authors confirm that in this report there are no personal data from patients&#46;</p></span></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Authors&#8217; contribution</span><p id="par0115" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">1&#46;</span><p id="par0120" class="elsevierStylePara elsevierViewall">Manager of the integrity of the study&#58; CS&#46;</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">2&#46;</span><p id="par0125" class="elsevierStylePara elsevierViewall">Original idea of the study&#58; CS&#44; OG&#44; CN&#46;</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">3&#46;</span><p id="par0130" class="elsevierStylePara elsevierViewall">Study design&#58; CS&#46;</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">4&#46;</span><p id="par0135" class="elsevierStylePara elsevierViewall">Data mining&#58; CS&#44; OG&#44; RG&#44; RS&#44; LB&#44; CN&#46;</p></li><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">5&#46;</span><p id="par0140" class="elsevierStylePara elsevierViewall">Data analysis and interpretation&#58; CS&#44; OG&#44; RG&#44; RS&#44; LB&#44; CN&#46;</p></li><li class="elsevierStyleListItem" id="lsti0030"><span class="elsevierStyleLabel">6&#46;</span><p id="par0145" class="elsevierStylePara elsevierViewall">Statistical analysis&#58; RS&#46;</p></li><li class="elsevierStyleListItem" id="lsti0035"><span class="elsevierStyleLabel">7&#46;</span><p id="par0150" class="elsevierStylePara elsevierViewall">Reference search&#58; CS&#44; OG&#44; RG&#44; RS&#44; LB&#44; CN&#46;</p></li><li class="elsevierStyleListItem" id="lsti0040"><span class="elsevierStyleLabel">8&#46;</span><p id="par0155" class="elsevierStylePara elsevierViewall">Writing&#58; CS&#44; OG&#44; RG&#44; RS&#44; LB&#44; CN&#46;</p></li><li class="elsevierStyleListItem" id="lsti0045"><span class="elsevierStyleLabel">9&#46;</span><p id="par0160" class="elsevierStylePara elsevierViewall">Critical review&#58; CS&#44; OG&#44; RG&#44; RS&#44; LB&#44; CN&#46;</p></li><li class="elsevierStyleListItem" id="lsti0050"><span class="elsevierStyleLabel">10&#46;</span><p id="par0165" class="elsevierStylePara elsevierViewall">Approval of final version&#58; CS&#44; OG&#44; RG&#44; RS&#44; LB&#44; CN&#46;</p></li></ul></p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Conflict of interests</span><p id="par0170" class="elsevierStylePara elsevierViewall">Dr&#46; Carmen Sebasti&#224;&#44; MD received a research grant from SERAM Industria&#46; The remaining authors reported no conflicts of interests&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:12 [
        0 => array:3 [
          "identificador" => "xres490304"
          "titulo" => "Abstract"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0005"
              "titulo" => "Objective"
            ]
            1 => array:2 [
              "identificador" => "abst0010"
              "titulo" => "Materials and methods"
            ]
            2 => array:2 [
              "identificador" => "abst0015"
              "titulo" => "Results"
            ]
            3 => array:2 [
              "identificador" => "abst0020"
              "titulo" => "Conclusions"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec512377"
          "titulo" => "Keywords"
        ]
        2 => array:3 [
          "identificador" => "xres490303"
          "titulo" => "Resumen"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0025"
              "titulo" => "Objetivo"
            ]
            1 => array:2 [
              "identificador" => "abst0030"
              "titulo" => "Material y m&#233;todos"
            ]
            2 => array:2 [
              "identificador" => "abst0035"
              "titulo" => "Resultados"
            ]
            3 => array:2 [
              "identificador" => "abst0040"
              "titulo" => "Conclusiones"
            ]
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec512376"
          "titulo" => "Palabras clave"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        5 => array:3 [
          "identificador" => "sec0010"
          "titulo" => "Materials and methods"
          "secciones" => array:3 [
            0 => array:2 [
              "identificador" => "sec0015"
              "titulo" => "Patients"
            ]
            1 => array:2 [
              "identificador" => "sec0020"
              "titulo" => "Image modalities"
            ]
            2 => array:2 [
              "identificador" => "sec0025"
              "titulo" => "Statistical analysis"
            ]
          ]
        ]
        6 => array:2 [
          "identificador" => "sec0030"
          "titulo" => "Results"
        ]
        7 => array:2 [
          "identificador" => "sec0035"
          "titulo" => "Discussion"
        ]
        8 => array:3 [
          "identificador" => "sec0040"
          "titulo" => "Ethical responsibilities"
          "secciones" => array:3 [
            0 => array:2 [
              "identificador" => "sec0045"
              "titulo" => "Protection of people and animals"
            ]
            1 => array:2 [
              "identificador" => "sec0050"
              "titulo" => "Data confidentiality"
            ]
            2 => array:2 [
              "identificador" => "sec0055"
              "titulo" => "Right to privacy and informed consent"
            ]
          ]
        ]
        9 => array:2 [
          "identificador" => "sec0060"
          "titulo" => "Authors&#8217; contribution"
        ]
        10 => array:2 [
          "identificador" => "sec0065"
          "titulo" => "Conflict of interests"
        ]
        11 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2013-08-04"
    "fechaAceptado" => "2014-02-17"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec512377"
          "palabras" => array:5 [
            0 => "Fetus"
            1 => "Congenital diaphragmatic hernia"
            2 => "Magnetic resonance imaging"
            3 => "Prenatal diagnosis"
            4 => "Doppler ultrasonography"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec512376"
          "palabras" => array:5 [
            0 => "Feto"
            1 => "Hernia diafragm&#225;tica cong&#233;nita"
            2 => "Resonancia magn&#233;tica"
            3 => "Diagn&#243;stico prenatal"
            4 => "Ecograf&#237;a Doppler"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To determine the usefulness of various parameters based on T2-weighted fetal magnetic resonance &#40;MR&#41; imaging measurements of the uninvolved lung for the neonatal prognosis of congenital diaphragmatic hernia &#40;CDH&#41;&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Materials and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">We used ultrasonography and MR imaging to study 28 fetuses with CDH&#46; We retrospectively analyzed &#40;a&#41; on fetal ultrasonography&#44; the observed-to-expected lung to head ratio &#40;O&#47;E LHR&#41; and the position of the liver&#44; and &#40;b&#41; on fetal MR imaging&#44; the lung-liver signal ratio &#40;LLSR&#41; and the lungcerebrospinal fluid ratio &#40;L&#47;CSF SR&#41;&#46; To determine the prognostic value of these parameters&#44; we compared them with the following postnatal parameters&#58; survival&#44; pulmonary hypertension&#44; need for oxygen supplementation&#44; and need for extracorporeal membrane oxygenation&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">We found significant differences between O&#47;E LHR and the need for postnatal extracorporeal membrane oxygenation &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;033&#41; and postnatal survival &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;01&#41;&#46; We also found significant differences in LLSR between fetuses that survived more than 45 days and those that died within 45 days &#40;1&#46;91 vs 2&#46;56&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;039&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">In fetuses with CDH&#44; the LLSR correlates with postnatal survival and can potentially be used as a prognostic parameter in CDH&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Objective"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Materials and methods"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Results"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusions"
          ]
        ]
      ]
      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Determinar el pron&#243;stico neonatal de la hernia diafragm&#225;tica cong&#233;nita &#40;HDC&#41; partiendo de la se&#241;al relativa del pulm&#243;n contralateral en secuencias r&#225;pidas T2 de resonancia magn&#233;tica &#40;RM&#41; fetal&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material y m&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Estudiamos mediante ecograf&#237;a y RM 28 fetos afectos de HDC y valoramos retrospectivamente en la ecograf&#237;a fetal la relaci&#243;n entre el cociente observado y el esperado del di&#225;metro axial m&#225;ximo del pulm&#243;n dividido por el per&#237;metro craneal &#40;O&#47;E LHR&#41; y la posici&#243;n hep&#225;tica&#44; y en la RM fetal el cociente de se&#241;al pulm&#243;n&#47;h&#237;gado &#40;LLSR&#41; y el cociente de se&#241;al pulm&#243;n&#47;l&#237;quido cefalorraqu&#237;deo &#40;L&#47;SF SR&#41;&#46; Para determinar su valor pron&#243;stico&#44; los comparamos con los par&#225;metros posnatales&#58; supervivencia&#44; hipertensi&#243;n pulmonar&#44; necesidad de ox&#237;geno y la necesidad de oxigenaci&#243;n con membrana extracorp&#243;rea&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Encontramos diferencias significativas entre O&#47;E LHR y la necesidad de oxigenaci&#243;n con membrana extracorp&#243;rea posnatal &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;033&#41; y la supervivencia posnatal &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&#44; y entre el LLSR de los fetos que sobrevivieron m&#225;s de 45 d&#237;as y los que no&#44; con unas medianas de 1&#44;91 y 2&#44;56 respectivamente &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;039&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">El LLSR se correlaciona con la supervivencia posnatal en fetos con HDC y puede potencialmente utilizarse como par&#225;metro pron&#243;stico de la HDC fetal&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Objetivo"
          ]
          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Material y m&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclusiones"
          ]
        ]
      ]
    ]
    "NotaPie" => array:2 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Please cite this article as&#58; Sebasti&#224; C&#44; Gomez O&#44; Salvador R&#44; Bu&#241;esch L&#44; Garcia R&#44; Nicolau C&#46; Cuantificaci&#243;n de la se&#241;al T2 pulmonar por resonancia magn&#233;tica como factor pron&#243;stico en las hernias diafragm&#225;ticas cong&#233;nitas fetales&#46; Radiolog&#237;a&#46; 2015&#59;57&#58;239&#8211;247&#46;</p>"
      ]
      1 => array:2 [
        "etiqueta" => "&#9734;&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0015">This study has been possible thanks to a research grant from <span class="elsevierStyleGrantSponsor" id="gs0005">SERAM Industria</span> 2009&#8211;2011&#46;</p>"
      ]
    ]
    "multimedia" => array:8 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 2100
            "Ancho" => 2625
            "Tamanyo" => 350458
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">T2-weighted axial image &#40;HASTE&#41;&#46; ROI for pulmonary &#40;ROIs in the right hyperintense area&#41; and hepatic measurements &#40;ROIs in the left hypointense area&#41;&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Figure 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 2100
            "Ancho" => 2625
            "Tamanyo" => 364211
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">T2-weighted sagittal image &#40;HASTE&#41;&#46; ROI for pulmonary and hepatic fetal measurements&#46;</p>"
        ]
      ]
      2 => array:7 [
        "identificador" => "fig0015"
        "etiqueta" => "Figure 3"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr3.jpeg"
            "Alto" => 2600
            "Ancho" => 3250
            "Tamanyo" => 419821
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">T2-weighted axial image &#40;HASTE&#41;&#46; Measurements of signal intensity of the contralateral lung and the cephalo-rachidian liquid&#46; Note the small size that the ROI needs to have to avoid errors due to partial volume of the bone marrow and the adjacent vertebra&#46;</p>"
        ]
      ]
      3 => array:7 [
        "identificador" => "fig0020"
        "etiqueta" => "Figure 4"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr4.jpeg"
            "Alto" => 1041
            "Ancho" => 1301
            "Tamanyo" => 98521
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">T2-weighted sagittal image corresponding to the contralateral lung of one left congenital diaphragmatic hernia &#40;arrow&#41; of a 35-week old fetus with a lung to liver signal ratio &#40;LLSR&#41; of 3&#46;7 and a lung to spinal fluid signal ratio &#40;L&#47;SF SR&#41; of 0&#46;87 with an excellent postnatal evolution&#46;</p>"
        ]
      ]
      4 => array:7 [
        "identificador" => "fig0025"
        "etiqueta" => "Figure 5"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr5.jpeg"
            "Alto" => 1041
            "Ancho" => 1301
            "Tamanyo" => 96737
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">T2-weighted sagittal image corresponding to the contralateral lung of one left congenital diaphragmatic hernia &#40;arrow&#41; of a 27-week old fetus with a lung to liver signal ratio &#40;LLSR&#41; of 1&#46;52 and a lung to spinal fluid signal ratio &#40;L&#47;SF SR&#41; of 0&#46;52&#46; The mother refused intrauterine therapy and the fetus died due to respiratory failure at birth&#46; The autopsy confirmed bilateral pulmonary hypoplasia&#46; Note the difference of signal between <a class="elsevierStyleCrossRefs" href="#fig0020">Figs&#46; 4 and 5</a>&#46;</p>"
        ]
      ]
      5 => array:7 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">GA&#58; gestational age measured in weeks&#44; maternal age measured in years&#59; L&#47;SF SR&#58; lung to spinal fluid signal ratio&#59; CRL&#58; cephalo-rachidian liquid&#59; LLSR&#58; lung to liver signal ratio&#59; O&#47;E LHR&#58; observed-to-expected lung area to head circumference ratio&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">Number of patients</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">Maternal age</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">32&#46;45 &#40;22&#46;81&#8211;38&#46;87&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleBold">Race</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Caucasian</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Arab</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Asian</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Latin</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleBold">Side of hernia</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Right</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Left</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleBold">Ultrasound</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">EG</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24&#46;14 &#40;20&#8211;35&#46;43&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">LHR</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;22 &#40;0&#46;52&#8211;2&#46;99&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">O&#47;E LHR</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">41&#46;92 &#40;19&#46;70&#8211;43&#46;28&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Liver location</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Lower&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Upper&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleBold">Magnetic resonance</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">GA</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">30&#46;14 &#40;25&#8211;32&#46;43&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Liver location</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Lower&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Upper&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Lung signal</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">177 &#40;75&#46;44&#8211;384&#46;78&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">CRL signal</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">280&#46;89 &#40;168&#46;93&#8211;524&#46;90&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Liver signal</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">72&#46;78 &#40;32&#46;06&#8211;174&#46;67&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">LLSR</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;4 &#40;0&#46;29&#8211;4&#46;62&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">L&#47;SF SR</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;61 &#40;0&#46;28&#8211;0&#46;89&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab779462.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Characteristics of the sample&#46;</p>"
        ]
      ]
      6 => array:7 [
        "identificador" => "tbl0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:3 [
          "leyenda" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">ECMO&#58; extracorporeal membrane oxygenation&#59; L&#47;SF SR&#58; lung to spinal fluid signal ratio&#59; LLSR&#58; lung to liver signal ratio&#59; O&#47;E LHR&#58; observed-to-expected lung area to head circumference ratio&#59; US&#58; ultrasound&#46;</p><p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">Outcomes are expressed as a median &#91;percentiles 25 and 75&#93; and as &#40;min&#44; max&#41; for quantitative variables and as the absolute frequency and percentage for qualitative variables&#46;</p>"
          "tablatextoimagen" => array:4 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">ECMO&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">YesNo&#46;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">NoNo&#46;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>-Value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">US liver location</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Lower&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13 &#40;56&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;75&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;624<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Upper&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10 &#40;43&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;25&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">US O&#47;E LHR</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">44&#46;15 &#91;33&#46;97&#59; 55&#46;19&#93; &#40;19&#46;7&#59; 99&#46;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">29&#46;79 &#91;25&#46;19&#59; 33&#46;82&#93; &#40;23&#46;43&#59; 35&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;033&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">L&#47;SF SR</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;61 &#91;0&#46;53&#59; 0&#46;73&#93; &#40;0&#46;42&#59; 1&#46;05&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;66 &#91;0&#46;55&#59; 0&#46;74&#93; &#40;0&#46;45&#59; 0&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;622&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">LLSR</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;4 &#91;1&#46;81&#59; 3&#46;19&#93; &#40;1&#46;22&#59; 4&#46;48&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;62 &#91;2&#46;15&#59; 3&#46;66&#93; &#40;2&#46;01&#59; 4&#46;36&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;622&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab779461.png"
              ]
            ]
            1 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Need for O<span class="elsevierStyleInf">2</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>30<span class="elsevierStyleHsp" style=""></span>d&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">&#8804;30No&#46;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">&#62;30No&#46;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">US liver location</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Lower&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9 &#40;56&#46;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;50&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Upper&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;43&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;50&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">US O&#47;E LHR</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">44&#46;7 &#91;34&#46;35&#59; 55&#46;75&#93; &#40;23&#46;43&#59; 99&#46;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">41&#46;66 &#91;30&#46;38&#59; 49&#46;5&#93; &#40;26&#46;95&#59; 49&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;376&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">L&#47;SF SR</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;6 &#91;0&#46;54&#59; 0&#46;69&#93; &#40;0&#46;43&#59; 0&#46;86&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;69 &#91;0&#46;53&#59; 0&#46;75&#93; &#40;0&#46;42&#59; 0&#46;77&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;617&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">LLSR</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;32 &#91;1&#46;68&#59; 3&#46;24&#93; &#40;1&#46;22&#59; 4&#46;48&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;98 &#91;2&#46;64&#59; 3&#46;77&#93; &#40;2&#46;51&#59; 4&#46;36&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;148&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab779464.png"
              ]
            ]
            2 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Pulmonary hypertension&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">YesNo&#46;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">NoNo&#46;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">US liver location</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Lower&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;50&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13 &#40;65&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;671<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Upper&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;50&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;35&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">US O&#47;ELHR</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">44&#46;7 &#91;38&#46;08&#59; 55&#46;75&#93; &#40;33&#46;82&#59; 56&#46;62&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">40&#46;42 &#91;29&#46;79&#59; 49&#46;5&#93; &#40;19&#46;7&#59; 99&#46;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;299&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">L&#47;SF SR</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;61 &#91;0&#46;54&#59; 0&#46;74&#93; &#40;0&#46;46&#59; 0&#46;86&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;61 &#91;0&#46;51&#59; 0&#46;7&#93; &#40;0&#46;32&#59; 1&#46;05&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;709&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">LLSR</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#46;13 &#91;2&#46;14&#59; 3&#46;78&#93; &#40;1&#46;81&#59; 4&#46;48&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;37 &#91;1&#46;68&#59; 2&#46;79&#93; &#40;1&#46;22&#59; 4&#46;36&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab779459.png"
              ]
            ]
            3 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Survival at 45 days&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Dead &#40;45<span class="elsevierStyleHsp" style=""></span>d&#41;No&#46;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Alive &#40;45<span class="elsevierStyleHsp" style=""></span>d&#41;No&#46;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">US liver location</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Lower&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;50&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14 &#40;63&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;653<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Upper&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;50&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8 &#40;36&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">US O&#47;E LHR</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">28&#46;77 &#91;21&#46;94&#59; 35&#93; &#40;19&#46;7&#59; 48&#46;48&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">44&#46;7 &#91;34&#46;73&#59; 55&#46;19&#93; &#40;23&#46;43&#59; 99&#46;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">L&#47;SF SR</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;56 &#91;0&#46;45&#59; 0&#46;64&#93; &#40;0&#46;32&#59; 0&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;62 &#91;0&#46;55&#59; 0&#46;73&#93; &#40;0&#46;42&#59; 1&#46;05&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;309&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">LLSR</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;91 &#91;1&#46;52&#59; 2&#46;14&#93; &#40;1&#46;22&#59; 2&#46;96&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;56 &#91;2&#46;28&#59; 3&#46;41&#93; &#40;1&#46;34&#59; 4&#46;48&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;039&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab779460.png"
              ]
            ]
          ]
          "notaPie" => array:1 [
            0 => array:3 [
              "identificador" => "tblfn0005"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Absolute frequency &#215;&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Results&#46;</p>"
        ]
      ]
      7 => array:7 [
        "identificador" => "tbl0015"
        "etiqueta" => "Table 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">CDH&#58; congenital diaphragmatic hernia&#59; L&#47;SF SR&#58; lung to spinal fluid signal ratio&#59; CRL&#58; cephalo-rachidian liquid&#59; LLSR&#58; lung to liver signal ratio&#59; CAM&#58; cystic adenomatoid malformation&#59; p&#58; patient&#59; ROI&#58; region of interest&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Author&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">&#35; of CDH&#47;total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Assessment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Outcomes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Terui et al&#46; &#40;2011&#41;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">23</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12 p CDH&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">L&#47;SF SRAverage of signal of the two lungs measured in all cuts&#46; ROI in LCR of 1&#8211;3<span class="elsevierStyleHsp" style=""></span>mm<span class="elsevierStyleSup">2</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Significant differences between survivors and neonatal deaths&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Cannie et al&#46; &#40;2011&#41;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">16</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11 p CDH&#47;105 without pulmonary alteration&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Average signal for each and every lung measured in all cuts with visible lung&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Significant differences between the pulmonary signal in normal fetuses and the ipsilateral lung to CDH no in the contralateral one&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Balassy et al&#46; &#40;2010&#41;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">12</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25 p CDH&#47;91 p controls&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">LLSR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">There were no significant differences between hernias with good and those with poor prognosis&#46; Lungs with CDH were smaller and with a lower signal intensity than controlsAll fetuses with LLSR<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>2 did not survive&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Matsushita et al&#46; &#40;2008&#41;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">24</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11 p&#47;4 CAM&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">LLSRLung and liver ROI 1&#8211;3<span class="elsevierStyleHsp" style=""></span>mm<span class="elsevierStyleSup">2</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No significant differences between survivors and non-survivorsTrend<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>2 survival&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Nishie et al&#46; &#40;2009&#41;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">21</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14 p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">LLSR &#40;median 3 lung ROI&#47;3 liver ROI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Significant differences between survivors and non-survivors with CDH&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Osada et al&#46; &#40;2004&#41;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">14</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11 p&#47;18 other conditions&#47;58 healthy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">L&#47;SF SR&#46; ROIs of the two lungs and CRL in the same cuts&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No significant differences between lungs with various conditions and normal lungsTrend<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;6 hypoplasia&#59; &#62;0&#46;9 normal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Keller et al&#46; &#40;2004&#41;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">22</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 p&#47;5 p other conditions&#47;35 healthy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">LLSRBiggest possible lung and liver ROIs&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No significant differences between lungs with various conditions and normal lungs&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Kuwashima et al&#46; &#40;2001&#41;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">10</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 p&#47;22 p other conditions&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">LLSRROI 1&#8211;3<span class="elsevierStyleHsp" style=""></span>mm<span class="elsevierStyleSup">2</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Significant differences between hypoplasic and normal lungsCutting value 2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab779463.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">Summary of bibliographic results&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:24 [
            0 => array:3 [
              "identificador" => "bib0125"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Observed to expected lung area to head circumference ratio in the prediction of survival in fetuses with isolated diaphragmatic hernia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Jani"
                            1 => "K&#46;H&#46; Nicolaides"
                            2 => "R&#46;L&#46; Keller"
                            3 => "A&#46; Benachi"
                            4 => "C&#46;F&#46; Peralta"
                            5 => "R&#46; Favre"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/uog.4052"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ultrasound Obstet Gynecol"
                        "fecha" => "2007"
                        "volumen" => "30"
                        "paginaInicial" => "67"
                        "paginaFinal" => "71"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17587219"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0130"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Association between intrapulmonary arterial Doppler parameters and degree of lung growth as measured by lung-to-head ratio in fetuses with congenital diaphragmatic hernia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "O&#46; Moreno-Alvarez"
                            1 => "E&#46; Hernandez-Andrade"
                            2 => "D&#46; Oros"
                            3 => "J&#46; Jani"
                            4 => "J&#46; Deprest"
                            5 => "E&#46; Gratacos"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/uog.5201"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ultrasound Obstet Gynecol"
                        "fecha" => "2008"
                        "volumen" => "31"
                        "paginaInicial" => "164"
                        "paginaFinal" => "170"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18196498"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0135"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Lung tissue perfusion in congenital diaphragmatic hernia and association with the lung-to head ratio an intrapulmonary artery pulsed Doppler"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "O&#46; Moreno-Alvarez"
                            1 => "R&#46; Cruz-Martinez"
                            2 => "E&#46; Hernandez-Andrade"
                            3 => "E&#46; Done"
                            4 => "O&#46; Gomez"
                            5 => "J&#46; Deprest"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/uog.7592"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ultrasound Obstet Gynecol"
                        "fecha" => "2010"
                        "volumen" => "35"
                        "paginaInicial" => "578"
                        "paginaFinal" => "582"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20178113"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0140"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The correlation between lung volume and liver herniation measurements by fetal MRI in isolated diaphragmatic hernia&#58; a systematic review and meta-analysis of observational studies"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Mayer"
                            1 => "P&#46; Klaritsh"
                            2 => "S&#46; Peersen"
                            3 => "E&#46; Done"
                            4 => "I&#46; Sandaite"
                            5 => "F&#46; Claus"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/pd.2839"
                      "Revista" => array:6 [
                        "tituloSerie" => "Prenat Diagn"
                        "fecha" => "2011"
                        "volumen" => "31"
                        "paginaInicial" => "1086"
                        "paginaFinal" => "1096"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21915885"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0145"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Re-evaluation of stomach position as a simple prognostic factor in fetal left congenital diaphragmatic hernia&#58; a multicenter survey in Japan"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "Y&#46; Kitano"
                            1 => "H&#46; Okuyama"
                            2 => "M&#46; Saito"
                            3 => "N&#46; Usui"
                            4 => "N&#46; Morikaa"
                            5 => "K&#46; Masumoto"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/uog.8892"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ultrasound Obstet Gynecol"
                        "fecha" => "2011"
                        "volumen" => "37"
                        "paginaInicial" => "277"
                        "paginaFinal" => "282"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21337653"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0150"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Fetal magnetic resonance imaging evaluation of congenital diaphragmatic hernia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "C&#46; Sebasti&#224;"
                            1 => "R&#46; Garcia"
                            2 => "O&#46; Gomez"
                            3 => "B&#46; Pa&#241;o"
                            4 => "C&#46; Nicolau"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:2 [
                        "tituloSerie" => "Radiologia"
                        "fecha" => "2013"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0155"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Diffusion-weighted MRI in lungs of normal fetuses and those with congenital diaphragmatic hernia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "M&#46; Cannie"
                            1 => "J&#46; Jani"
                            2 => "F&#46; de Keyzer"
                            3 => "I&#46; Roebben"
                            4 => "S&#46; Dymarkowski"
                            5 => "J&#46; Deprest"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/uog.7326"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ultrasound Obstet Gynecol"
                        "fecha" => "2009"
                        "volumen" => "34"
                        "paginaInicial" => "678"
                        "paginaFinal" => "686"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19866446"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0160"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Performance of an automatic quantitative ultrasound analysis of the fetal lung to predict fetal lung maturity"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Palacio"
                            1 => "T&#46; Cobo"
                            2 => "M&#46; Martinez-Terr&#243;n"
                            3 => "G&#46;A&#46; Ratt&#225;"
                            4 => "E&#46; Bonet-Carn&#233;"
                            5 => "I&#46; Amat-Roldan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ajog.2012.09.027"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Obstet Gynecol"
                        "fecha" => "2012"
                        "volumen" => "207"
                        "paginaInicial" => "504&#46;e1"
                        "paginaFinal" => "504&#46;e5"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23174391"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0165"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "In vivo 1&#40;H&#41; magnetic resonance spectroscopy of amniotic fluid and fetal lung at 1&#46;5<span class="elsevierStyleHsp" style=""></span>T&#58; technical challenges"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46; Kim"
                            1 => "K&#46; Vahidi"
                            2 => "A&#46;B&#46; Caughey"
                            3 => "F&#46;V&#46; Coakley"
                            4 => "D&#46;B&#46; Vigneron"
                            5 => "J&#46; Kurhanewicz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/jmri.21528"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Magn Reson Imaging"
                        "fecha" => "2008"
                        "volumen" => "28"
                        "paginaInicial" => "1033"
                        "paginaFinal" => "1038"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18821604"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0170"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Low-intensity fetal lungs on MRI may suggest the diagnosis of pulmonary hypoplasia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Kuwashima"
                            1 => "Nishimura"
                            2 => "F&#46; Iimura"
                            3 => "T&#46; Kohno"
                            4 => "Watanabe h"
                            5 => "A&#46; Kohno"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s002470100512"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatr Radiol"
                        "fecha" => "2001"
                        "volumen" => "31"
                        "paginaInicial" => "669"
                        "paginaFinal" => "672"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11512012"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0175"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Fetal lung-to-liver signal intensity ratio at MR imaging&#58; development of a normal scale and possible role in predicting pulmonary hypoplasia in utero"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "L&#46;J&#46; Brewerton"
                            1 => "R&#46;S&#46; Chari"
                            2 => "Y&#46; Liang"
                            3 => "R&#46; Bhargava"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Radiology"
                        "fecha" => "2005"
                        "volumen" => "253"
                        "paginaInicial" => "1005"
                        "paginaFinal" => "1010"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0180"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Assessment of lung development in isolated congenital diaphragmatic hernia using signal intensity ratios on fetal MR imaging"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46; Balassy"
                            1 => "G&#46; Kasprian"
                            2 => "P&#46;C&#46; Brugger"
                            3 => "M&#46; Weber"
                            4 => "B&#46; Csapo"
                            5 => "C&#46; Herold"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00330-009-1633-x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Radiol"
                        "fecha" => "2010"
                        "volumen" => "20"
                        "paginaInicial" => "829"
                        "paginaFinal" => "837"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19890648"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0185"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prediction of outcome in isolated congenital diaphragmatic hernia and its consequences for fetal therapy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "L&#46; Gucciardo"
                            1 => "J&#46; Deprest"
                            2 => "E&#46; Done&#8217;"
                            3 => "T&#46; van Mieghem"
                            4 => "M&#46; van de Velde"
                            5 => "E&#46; Gratacos"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.bpobgyn.2007.08.006"
                      "Revista" => array:6 [
                        "tituloSerie" => "Best Pract Res Clin Obstet Gynaecol"
                        "fecha" => "2008"
                        "volumen" => "22"
                        "paginaInicial" => "123"
                        "paginaFinal" => "138"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18082455"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0190"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Quantitative and qualitative evaluations of fetal lung with MR imaging"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "H&#46; Osada"
                            1 => "K&#46; Kahu"
                            2 => "K&#46; Masuda"
                            3 => "Y&#46; Litsuda"
                            4 => "K&#46; Seki"
                            5 => "S&#46; Sekiya"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1148/radiol.2313021689"
                      "Revista" => array:6 [
                        "tituloSerie" => "Radiology"
                        "fecha" => "2004"
                        "volumen" => "231"
                        "paginaInicial" => "887"
                        "paginaFinal" => "892"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15118120"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0195"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "T2 quantifications of lungs in the fetal lamb with experimentally-induced congenital diaphragmatic hernia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "L&#46; Breysem"
                            1 => "H&#46; Bosmans"
                            2 => "J&#46; Jani"
                            3 => "X&#46; Roubliova"
                            4 => "M&#46; Cannie"
                            5 => "J&#46; Deprest"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1159/000097115"
                      "Revista" => array:6 [
                        "tituloSerie" => "Fetal Diagn Ther"
                        "fecha" => "2007"
                        "volumen" => "22"
                        "paginaInicial" => "143"
                        "paginaFinal" => "148"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17139173"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0200"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "T2 quantifications of fetal lungs at MRI-normal ranges"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "M&#46; Cannie"
                            1 => "J&#46; Jani"
                            2 => "F&#46; de Keyzer"
                            3 => "I&#46; Roebben"
                            4 => "L&#46; Breysem"
                            5 => "J&#46; Deprest"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/pd.2746"
                      "Revista" => array:6 [
                        "tituloSerie" => "Prenat Diagn"
                        "fecha" => "2011"
                        "volumen" => "31"
                        "paginaInicial" => "705"
                        "paginaFinal" => "711"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21425299"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0205"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pulmonary acinar development in diaphragmatic hernia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "Y&#46; Nakamura"
                            1 => "I&#46; Yamamoto"
                            2 => "S&#46; Fukuda"
                            3 => "T&#46; Hashimoto"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Pathol Lab Med"
                        "fecha" => "1991"
                        "volumen" => "115"
                        "paginaInicial" => "372"
                        "paginaFinal" => "376"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2012498"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0210"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Lung maturation in neonatal respiratory disorders"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "A&#46; Greenough"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:4 [
                        "titulo" => "Pediatric respiratory disease"
                        "paginaInicial" => "13"
                        "paginaFinal" => "26"
                        "serieFecha" => "2006"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0215"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "MRI of normal and pathological fetal lung development"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "G&#46; Kasprian"
                            1 => "C&#46; Balassy"
                            2 => "P&#46;C&#46; Brugger"
                            3 => "D&#46; Prayer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ejrad.2005.11.031"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Radiol"
                        "fecha" => "2006"
                        "volumen" => "57"
                        "paginaInicial" => "261"
                        "paginaFinal" => "270"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16413987"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0220"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Demonstration of changes in fetal liver erythropoiesis using echo-planar magnetic resonance imaging"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "K&#46;R&#46; Duncan"
                            1 => "P&#46;N&#46; Baker"
                            2 => "P&#46;A&#46; Gowland"
                            3 => "B&#46; Issa"
                            4 => "R&#46; Moore"
                            5 => "B&#46; Worthington"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Physiol"
                        "fecha" => "1997"
                        "volumen" => "273"
                        "paginaInicial" => "G965"
                        "paginaFinal" => "G967"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9357842"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0225"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "MR prediction of postnatal outcomes in felt-sided congenital diaphragmatic hernia using right lung signal intensity&#58; comparison with that using right lung volume"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Nishie"
                            1 => "T&#46; Tajima"
                            2 => "Y&#46; Asayama"
                            3 => "K&#46; Ishigami"
                            4 => "M&#46; Hirakawa"
                            5 => "T&#46; Nakayama"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/jmri.21829"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Magn Reson Imaging"
                        "fecha" => "2009"
                        "volumen" => "30"
                        "paginaInicial" => "112"
                        "paginaFinal" => "120"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19557726"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0230"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "MR assessment of fetal lung development using lung volumes and signal intensities"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "T&#46;M&#46; Keller"
                            1 => "A&#46; Rake"
                            2 => "S&#46;C&#46;S&#46; Michel"
                            3 => "B&#46; Seifert"
                            4 => "J&#46; Wisser"
                            5 => "B&#46; Marincek"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00330-004-2256-x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Radiol"
                        "fecha" => "2004"
                        "volumen" => "14"
                        "paginaInicial" => "984"
                        "paginaFinal" => "989"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15014973"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0235"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prediction of postnatal outcomes in congenital diaphragmatic hernia using MRI signal intensity of the fetal lung"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "K&#46; Terui"
                            1 => "A&#46; Omoto"
                            2 => "T&#46; Hishiki"
                            3 => "T&#46; Saito"
                            4 => "Y&#46; Sato"
                            5 => "M&#46; Nakata"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1038/jp.2010.119"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Perinatol"
                        "fecha" => "2011"
                        "volumen" => "31"
                        "paginaInicial" => "269"
                        "paginaFinal" => "273"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21052047"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0240"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "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"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Matsushita"
                            1 => "K&#46; Ishii"
                            2 => "M&#46; Tamura"
                            3 => "Y&#46; Takahashi"
                            4 => "T&#46; Kamura"
                            5 => "K&#46; Takakuwa"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1447-0756.2008.00754.x"
                      "Revista" => array:5 [
                        "tituloSerie" => "J Obstet Gynaecol Res"
                        "fecha" => "2008"
                        "volumen" => "34"
                        "paginaInicial" => "162"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18412776"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/21735107/0000005700000003/v2_201504291245/S2173510715000257/v2_201504291245/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "8098"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Original reports"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/21735107/0000005700000003/v2_201504291245/S2173510715000257/v2_201504291245/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173510715000257?idApp=UINPBA00004N"
]

Article information

ISSN: 21735107
Original language: English

DOI:10.1016/j.rxeng.2014.02.006

The statistics are updated each day

Year/Month	Html	Pdf	Total

2024 July	1	0	1
2024 May	2	0	2
2024 April	1	0	1
2024 March	1	0	1
2024 February	3	0	3
2023 December	1	0	1
2023 August	1	0	1
2023 January	1	0	1
2018 May	0	1	1
2018 April	16	4	20
2018 March	5	0	5
2018 February	7	2	9
2018 January	8	11	19
2017 December	9	2	11
2017 November	4	9	13
2017 October	13	3	16
2017 September	13	10	23
2017 August	19	23	42
2017 July	24	9	33
2017 June	24	15	39
2017 May	23	1	24
2017 April	35	6	41
2017 March	29	36	65
2017 February	16	7	23
2017 January	9	5	14
2016 December	18	6	24
2016 November	13	6	19
2016 October	24	8	32
2016 September	17	6	23
2016 August	6	5	11
2016 July	19	5	24
2016 June	40	9	49
2016 May	29	15	44
2016 April	26	10	36
2016 March	30	10	40
2016 February	29	16	45
2016 January	29	15	44
2015 December	31	9	40
2015 November	23	12	35
2015 October	0	1	1
2015 June	0	1	1
2015 May	0	1	1
2015 April	1	0	1

Show all

Indexed in:

Follow us:

Statistics

Indexed in:

Follow us:

Statistics

Subscribe to our newsletter