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Diagnosis of Congenital Diaphragmatic Hernia

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Fetal MRI

Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

Abstract

With advances in ultrasound technology, congenital diaphragmatic hernia (CDH) is easily diagnosed prenatally. In contrast, prenatal prognostication remains a challenge. In view of the current availability of fetal therapy this becomes even more important. To date, one of the most studied markers is the lung-area to head circumference ratio and has been shown in large studied to be predictive of postnatal outcome in terms of survival and also morbidity. Since the fetal lung is a fluid filled structure hence has high signal intensity on T2-WI, it can be easily discernible from the surrounding structures using fetal magnetic resonance imaging (MRI). This remains so even in case of oligohydramnios and obesity, conditions that make appropriate ultrasound evaluation difficult and inaccurate. The advantage of prenatal assessment in CDH using fetal MRI is that both lungs can be measured accurately, prediction can be adjusted to fetal biometry using the fetal body volume and intrathoracic position of the liver can be quantified, given a more accurate prediction of postnatal survival rather than the simple semiquantitative assessment of liver position. Further research using fetal MRI is directed towards the assessment of lungs at the microstructural level.

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Authors and Affiliations

  1. Department of Radiology, University Hospital Brugmann, Brussels, Belgium

    Mieke Cannie

  2. Departments of Radiology, UZ Brussels, Vrije Universiteit Brussels, Brussels, Belgium

    Mieke Cannie

  3. Department of Obstetrics and Gynaecology, Section Fetal Medicine and Therapy, University Hospital Brugmann, Brussels, Belgium

    Jacques Jani

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Correspondence to Mieke Cannie .

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  1. Klinik für Radiodiagnostik, Medizinische Universität Wien, Währinger Gürtel 18-20, Wien, 1090, Austria

    Daniela Prayer

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Cannie, M., Jani, J. (2010). Diagnosis of Congenital Diaphragmatic Hernia. In: Prayer, D. (eds) Fetal MRI. Medical Radiology(). Springer, Berlin, Heidelberg. https://doi.org/10.1007/174_2010_21

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