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Correlation between US and MRI for prenatal lung volumetry in diaphragmatic hernia, and use of Doppler to identify the ipsilateral lung cap

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Abstract

Background

Pulmonary hypoplasia is a common cause of neonatal death.

Objective

To describe the correlation between relative fetal lung volume (RFLV) and lung-to-head ratio (LHR) in fetuses with unilateral diaphragmatic hernia. Additionally, to describe identification of the ipsilateral lung cap by power Doppler.

Materials and methods

Single-institution study of consecutive fetuses with diaphragmatic hernia. LHR (by US) and RFLV (by MRI) were correlated in fetuses with and without an ipsilateral lung cap seen at MRI. In four, color/power Doppler was used to follow the pulmonary artery of the ipsilateral lung to identify the compressed cap.

Results

The study included 48 fetuses of 20-38 weeks’ gestational age (mean, 26 weeks). Mean LHR was 1.52 (range, 0.6-3) in fetuses with a lung cap and 1.15 (range, 0.6-2.58) in fetuses without (P = 0.043). Mean RFLV was 47.4% (range, 18-80%) in fetuses with and 32.9% (range, 14-57%) in fetuses without a lung cap (P = 0.005). RFLV and LHR correlated (r = 0.41, P = 0.01 in those with a cap; r = 0.50, P = 0.05 in those without). Power Doppler identified the ipsilateral lung cap and pulsed Doppler confirmed pulmonary vascularization in four of four fetuses.

Conclusion

LHR underestimates lung volume in fetuses with an ipsilateral lung cap. Power Doppler may be useful for identifying the cap.

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Authors and Affiliations

  1. Department of Pediatric Radiology, University Children’s Hospital Vall d’Hebron, Ps. Vall d’Hebron 119-129, 08035, Barcelona, Spain

    Amparo Castellote, Sandra Mencho, Lina Cadavid, Joaquim Piqueras & Goya Enriquez

  2. Department of Obstetrics and Gynecology, University Hospital Vall d’Hebron, Barcelona, Spain

    Elena Carreras & Teresa Higueras

Authors
  1. Amparo Castellote
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  2. Sandra Mencho
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  3. Elena Carreras
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  4. Teresa Higueras
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  5. Lina Cadavid
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  6. Joaquim Piqueras
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  7. Goya Enriquez
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Correspondence to Amparo Castellote.

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Castellote, A., Mencho, S., Carreras, E. et al. Correlation between US and MRI for prenatal lung volumetry in diaphragmatic hernia, and use of Doppler to identify the ipsilateral lung cap. Pediatr Radiol 41, 1569–1577 (2011). https://doi.org/10.1007/s00247-011-2200-6

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  • DOI: https://doi.org/10.1007/s00247-011-2200-6

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