Fetal head and neck masses: MRI prediction of significant morbidity

Timothy W. Ng, Yin Xi, David T Schindel, Angela Beavers, Patricia C Santiago-Munoz, April A. Bailey, Diane M. Twickler

Research output: Contribution to journalArticle

Abstract

OBJECTIVE. The purpose of this study is to determine which MRI parameters of fetal head and neck masses predict high-morbidity neonatal outcomes, including ex utero intrapartum treatment (EXIT) procedure. MATERIALS AND METHODS. This retrospective study (2004-2016) included parameters of polyhydramnios (based on largest vertical pocket), mass effect on the trachea, mass midline extension, and morphologic grade and size of masses. The morbid cohort included those requiring an EXIT procedure, difficult intubation at delivery, or lethal outcome. Predictive modeling with a multivariable logistic regression and ROC analysis was then performed. RESULTS. Of 36 fetuses, five were delivered by EXIT procedures, there was one neonatal death within 12 hours after delivery, and another neonate required multiple intubation attempts. The remaining 29 fetuses were delivered at outside institutions with no interventions or neonatal morbidity. The largest vertical pocket and mass effect on the trachea were selected as independent predictors by the logistic regression. The cross-validated ROC AUC was 0.951 (95% CI, 0.8795-1). CONCLUSION. The largest vertical pocket measurement and mass effect on the trachea were the most contributory MRI parameters that predicted significant morbidity in fetuses with masses of the face and neck, along with other significant parameters. These parameters predict significant morbid neonatal outcomes, including the need for EXIT procedures.

Original languageEnglish (US)
Pages (from-to)215-221
Number of pages7
JournalAmerican Journal of Roentgenology
Volume212
Issue number1
DOIs
StatePublished - Jan 1 2019

Fingerprint

Neck
Trachea
Head
Morbidity
Fetus
Intubation
Logistic Models
Polyhydramnios
Therapeutics
ROC Curve
Area Under Curve
Retrospective Studies
Regression Analysis

Keywords

  • Craniofacial lesions
  • Ex utero intrapartum treatment (EXIT)
  • Fetal tumor
  • MRI

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Fetal head and neck masses : MRI prediction of significant morbidity. / Ng, Timothy W.; Xi, Yin; Schindel, David T; Beavers, Angela; Santiago-Munoz, Patricia C; Bailey, April A.; Twickler, Diane M.

In: American Journal of Roentgenology, Vol. 212, No. 1, 01.01.2019, p. 215-221.

Research output: Contribution to journalArticle

Ng, Timothy W. ; Xi, Yin ; Schindel, David T ; Beavers, Angela ; Santiago-Munoz, Patricia C ; Bailey, April A. ; Twickler, Diane M. / Fetal head and neck masses : MRI prediction of significant morbidity. In: American Journal of Roentgenology. 2019 ; Vol. 212, No. 1. pp. 215-221.
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