Pulmonary vasculature development in congenital diaphragmatic hernia: a novel automated quantitative imaging analysis

Emrah Aydin, Furkan Durmus, Nilhan Torlak, Marc Oria, Nilgün Güler Bayazit, Esin Öztürk Isik, Birol Aslanyürek, Jose L. Peiro
Cincinnati Children’s Hospital Medical Center and University of Cincinnati College of Medicine. Boğaziçi University. Yildiz Technical University.
United States and Turkey

Pediatric Surgery International
Pediatr Surg Int 2024; 40:
DOI: 10.1007/s00383-024-05643-x

Abstract
Purpose: Impaired fetal lung vasculature determines the degree of pulmonary hypertension in the congenital diaphragmatic hernia (CDH). This study aims to demonstrate the morphometric measurements that differ in pulmonary vessels of fetuses with CDH.
Methods: Nitrofen-induced CDH Sprague-Dawley rat fetuses were scanned with microcomputed tomography. The analysis of the pulmonary vascular tree was performed with artificial intelligence.
Results: The number of segments in CDH was significantly lower than that in the control group on the left (U = 2.5, p = 0.004) and right (U = 0, p = 0.001) sides for order 1(O1), whereas there was a significant difference only on the right side for O2 and O3. The pooled element numbers in the control group obeyed Horton’s law (R2 = 0.996 left and R2 = 0.811 right lungs), while the CDH group broke it. Connectivity matrices showed that the average number of elements of O1 springing from elements of O1 on the left side and the number of elements of O1 springing from elements of O3 on the right side were significantly lower in CDH samples.
Conclusion: According to these findings, CDH not only reduced the amount of small order elements, but also destroyed the fractal structure of the pulmonary arterial trees.

Category
Class III. Pulmonary Hypertension Associated with Lung Hypoplasia
Animal Models of Pulmonary Vascular Disease and Therapy
Pulmonary Vascular Pathology

Age Focus: Pediatric Pulmonary Vascular Disease

Fresh or Filed Publication: Fresh (PHresh). Less than 1-2 years since publication

Article Access
Free PDF File or Full Text Article Available Through PubMed or DOI: No

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