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

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Abstract

Objectives

To investigate developmental changes in the apparently unaffected contralateral lung by using signal intensity ratios (SIR) and lung volumes (LV), and to search for correlation with clinical outcome.

Methods

Twenty-five fetuses (22–37 weeks’ gestation) were examined. Lung/liver signal intensity ratios (LLSIR) were assessed on T1-weighted and T2-weighted sequences for both lungs, then together with LV compared with age-matched controls of 91 fetuses by using the U test. Differences in LLSIRs and lung volumes were correlated with neonatal outcomes.

Results

LLSIRs in fetuses with congenital diaphragmatic hernia (CDH) were significantly higher in both lungs on T1-weighted images and significantly lower on T2-weighted images, compared with normals (p < 0.05), increasing on T2-weighted imaging and decreasing on T1-weighted imaging during gestation. Total LV were significantly smaller in the CDH group than in controls (p < 0.05). No significant differences in LLSIR of the two lungs were found. Outcomes correlated significantly with total LV, but not with LLSIR.

Conclusion

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.

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Authors and Affiliations

  1. Department of Radiology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria

    Csilla Balassy, Gregor Kasprian, Michael Weber, Christian Herold & Daniela Prayer

  2. Centre of Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria

    Peter C. Brugger

  3. Department of Obstetrics and Gyneocology, Medical University of Vienna, Vienna, Austria

    Bence Csapo

Authors
  1. Csilla Balassy
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  2. Gregor Kasprian
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  4. Michael Weber
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  6. Christian Herold
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  7. Daniela Prayer
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Correspondence to Csilla Balassy.

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Balassy, C., Kasprian, G., Brugger, P.C. et al. Assessment of lung development in isolated congenital diaphragmatic hernia using signal intensity ratios on fetal MR imaging. Eur Radiol 20, 829–837 (2010). https://doi.org/10.1007/s00330-009-1633-x

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  • DOI: https://doi.org/10.1007/s00330-009-1633-x

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