Assessment of lung development in isolated congenital diaphragmatic hernia using signal intensity ratios on fetal MR imaging

Bálassy, Csilla; Kasprian, Gregor; Brugger, Peter C.; Weber, Michael; Csapó, B; Herold, Christian; Prayer, Daniela

doi:10.1007/s00330-009-1633-x

Cited by 39 publications

(33 citation statements)

References 47 publications

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“…It has also been used to predict the need for extracorporeal membrane oxygenation [35,36] . Recently, the group of Prayer demonstrated that lung signal intensity ratios did not have any additional value in predicting prognosis [37] . MRI can also demonstrate the presence of liver herniation.…”

Section: Imaging Anatomical Parameters As Prognostic Predictors In Cdhmentioning

confidence: 99%

Prenatal Anatomical Imaging in Fetuses with Congenital Diaphragmatic Hernia

Claus¹,

Sandaite²,

DeKoninck³

et al. 2010

Fetal Diagn Ther

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Section: Imaging Anatomical Parameters As Prognostic Predictors In Cdhmentioning

confidence: 99%

Prenatal Anatomical Imaging in Fetuses with Congenital Diaphragmatic Hernia

Claus¹,

Sandaite²,

DeKoninck³

et al. 2010

Fetal Diagn Ther

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“…22,23 Although the pathogenesis of pulmonary hypoplasia in CDH remains poorly understood, the fetal lung fluid has a key role in normal lung development as is mentioned. 24,25 Recent studies using MRI signal intensity for fetuses with CDH showed both positive 26 and negative 27,28 data for prediction of survival prognosis.…”

Section: Discussionmentioning

confidence: 99%

Prediction of postnatal outcomes in congenital diaphragmatic hernia using MRI signal intensity of the fetal lung

et al. 2010

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Objective: Prognostic prediction in prenatally diagnosed congenital diaphragmatic hernia (CDH) is needed. The aim of the study was to evaluate magnetic resonance imaging (MRI) signal intensity of the fetal lung as a predictor of prognosis in CDH.Study Design: The subjects consisted of 12 fetuses with prenatally diagnosed CDH, who were treated soon after the birth in our institution. They all underwent MRI at 29 to 37 weeks of gestation. The ratio of the lung signal intensity to the spinal fluid signal intensity (L/SF) was calculated using region-of-interest analysis of T2-weighted images. The relationship between L/SF and clinical data was then examined.Result: L/SF were significantly larger in survivors compared with deaths (0.815 vs 0.614, P<0.05). In survivors, L/SF significantly correlated with duration of tracheal intubation (rs ¼ À0.938, P<0.01).Conclusion: L/SF is a unique factor to predict the survival prognosis and likely to quantify the degree of pulmonary hypoplasia in CDH.

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“…Lung volumes increase significantly with time, but longterm follow-up studies in children with surgical repair of congenital diaphragmatic hernias have shown persistent reduced lung perfusion in the lung ipsilateral to the hernia compared to the contralateral lung [43]. Recently, Balassy et al [44] assessed development of both lungs in patients with isolated congenital diaphragmatic hernia by using lung/liver signal intensity ratios on T1-and T2-W images. They found that lung/liver signal intensity ratios were significantly higher in both lungs on T1-W and significantly lower on T2-W images compared with normal lungs and concluded that although these changes seem to reflect developmental impairment in both lungs, they provide no additional information in predicting final outcome.…”

Section: Prenatal Diagnosis Of Congenital Diaphragmatic Defectsmentioning

confidence: 99%

Imaging findings in fetal diaphragmatic abnormalities

Alamo

Gudinchet

Meuli³

2015

Pediatr Radiol

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Imaging plays a key role in the detection of a diaphragmatic pathology in utero. US is the screening method, but MRI is increasingly performed. Congenital diaphragmatic hernia is by far the most often diagnosed diaphragmatic pathology, but unilateral or bilateral eventration or paralysis can also be identified. Extralobar pulmonary sequestration can be located in the diaphragm and, exceptionally, diaphragmatic tumors or secondary infiltration of the diaphragm from tumors originating from an adjacent organ have been observed in utero. Congenital abnormalities of the diaphragm impair normal lung development. Prenatal imaging provides a detailed anatomical evaluation of the fetus and allows volumetric lung measurements. The comparison of these data with those from normal fetuses at the same gestational age provides information about the severity of pulmonary hypoplasia and improves predictions about the fetus's outcome. This information can help doctors and families to make decisions about management during pregnancy and after birth. We describe a wide spectrum of congenital pathologies of the diaphragm and analyze their embryological basis. Moreover, we describe their prenatal imaging findings with emphasis on MR studies, discuss their differential diagnosis and evaluate the limits of imaging methods in predicting postnatal outcome.

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Assessment of lung development in isolated congenital diaphragmatic hernia using signal intensity ratios on fetal MR imaging

Abstract: Changes in LLSIR seem to reflect developmental impairment in CDH; however, they provide no additional information in predicting outcome. LV remains the best indicator on fetal MR imaging of neonatal survival in isolated, left-sided CDH.

Cited by 39 publications

References 47 publications

Prenatal Anatomical Imaging in Fetuses with Congenital Diaphragmatic Hernia

Prenatal Anatomical Imaging in Fetuses with Congenital Diaphragmatic Hernia

Prediction of postnatal outcomes in congenital diaphragmatic hernia using MRI signal intensity of the fetal lung

Imaging findings in fetal diaphragmatic abnormalities

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