Abstract
Prenatal sonography provides a sensitive detection of most fetal thoracic pathologies. However, the specificity and reliability in the diagnosis as well as prediction of postnatal outcome may be further optimized by fetal MR imaging. Due to the excellent tissue contrast of fetal MRI and the ability to provide information on the chemical composition of certain lung lesions using different MR sequences, this imaging modality can add further diagnostic information, which may be even superior to the commonly used postnatal imaging procedures. Thus, fetal MR of thoracic pathologies finally constitutes a valuable preoperative imaging tool. This chapter generally reviews the most frequently encountered thoracic pathologies of the fetus focusing on pulmonary hypoplasia and cystic lung lesions and describes their MR imaging appearance on a variety of MR sequences.
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References
Achiron R, Hegesh J, Yagel S (2004a) Fetal lung lesions: a spectrum of disease. New classification based on pathogenesis, two-dimensional and color Doppler ultrasound. Ultrasound Obstet Gynecol 24:107–114
Achiron R, Zalel Y, Lipitz S, Hegesh J, Mazkereth R, Kuint J, Jacobson J, Yagel S (2004b) Fetal lung dysplasia: clinical outcome based on a new classification system. Ultrasound Obstet Gynecol 24:127–133
Adzick NS, Harrison MR, Crombleholme TM, Flake AW, Howell LJ (1998) Fetal lung lesions: management and outcome. Am J Obstet Gynecol 179:884–889
Adzick NS, Harrison MR, Glick PL, Golbus MS, Anderson RL, Mahony BS, Callen PW, Hirsch JH, Luthy DA, Filly RA et al (1985) Fetal cystic adenomatoid malformation: prenatal diagnosis and natural history. J Pediatr Surg 20:483–488
Albuquerque CA, Smith KR, Saywers TE, Johnson C, Cock ML, Harding R (2002) Relation between oligohydramnios and spinal flexion in the human fetus. Early Hum Dev 68:119–126
Askenazi SS, Perlman M (1979) Pulmonary hypoplasia: lung weight and radial alveolar count as criteria of diagnosis. Arch Dis Child 54:614–618
Becmeur F, Horta-Geraud P, Donato L, Sauvage P (1998) Pulmonary sequestrations: prenatal ultrasound diagnosis, treatment, and outcome. J Pediatr Surg 33:492–496
Bunduki V, Ruano R, da Silva MM, Miguelez J, Miyadahira S, Maksoud JG, Zugaib M (2000) Prognostic factors associated with congenital cystic adenomatoid malformation of the lung. Prenat Diagn 20:459–464
Cangiarella J, Greco MA, Askin F, Perlman E, Goswami S, Jagirdar J (1995) Congenital cystic adenomatoid malformation of the lung: insights into the pathogenesis utilizing quantitative analysis of vascular marker CD34 (QBEND-10) and cell proliferation marker MIB-1. Mod Pathol 8:913–918
Cass DL, Crombleholme TM, Howell LJ, Stafford PW, Ruchelli ED, Adzick NS (1997) Cystic lung lesions with systemic arterial blood supply: a hybrid of congenital cystic adenomatoid malformation and bronchopulmonary sequestration. J Pediatr Surg 32:986–990
Cavoretto P, Molina F, Poggi S, Davenport M, Nicolaides KH (2008) Prenatal diagnosis and outcome of echogenic fetal lung lesions. Ultrasound Obstet Gynecol 32:769–783
Ch’In KY, Tang MY (1949) Congenital adenomatoid malformation of one lobe of a lung with general anasarca. Arch Pathol (Chic) 48:221–229
Clements BS, Warner JO (1987) Pulmonary sequestration and related congenital bronchopulmonary-vascular malformations: nomenclature and classification based on anatomical and embryological considerations. Thorax 42:401–408
Clements BS, Warner JO, Shinebourne EA (1987) Congenital bronchopulmonary vascular malformations: clinical application of a simple anatomical approach in 25 cases. Thorax 42:409–416
Davenport M, Warne SA, Cacciaguerra S, Patel S, Greenough A, Nicolaides K (2004) Current outcome of antenally diagnosed cystic lung disease. J Pediatr Surg 39:549–556
De Paepe ME, Friedman RM, Gundogan F, Pinar H (2005) Postmortem lung weight/body weight standards for term and preterm infants. Pediatr Pulmonol 40:445–448
Dhingsa R, Coakley FV, Albanese CT, Filly RA, Goldstein R (2003) Prenatal sonography and MR imaging of pulmonary sequestration. AJR Am J Roentgenol 180:433–437
Dolkart LA, Reimers FT, Helmuth WV, Porte MA, Eisinger G (1992) Antenatal diagnosis of pulmonary sequestration: a review. Obstet Gynecol Surv 47:515–520
Gerle RD, Jaretzki A 3rd, Ashley CA, Berne AS (1968) Congenital bronchopulmonary-foregut malformation. Pulmonary sequestration communicating with the gastrointestinal tract. N Engl J Med 278:1413–1419
Grethel EJ, Wagner AJ, Clifton MS, Cortes RA, Farmer DL, Harrison MR, Nobuhara KK, Lee H (2007) Fetal intervention for mass lesions and hydrops improves outcome: a 15-year experience. J Pediatr Surg 42:117–123
Hubbard AM, Crombleholme TM (1998) Anomalies and malformations affecting the fetal/neonatal chest. Semin Roentgenol 33:117–125
Illanes S, Hunter A, Evans M, Cusick E, Soothill P (2005) Prenatal diagnosis of echogenic lung: evolution and outcome. Ultrasound Obstet Gynecol 26:145–149
Khosa JK, Leong SL, Borzi PA (2004) Congenital cystic adenomatoid malformation of the lung: indications and timing of surgery. Pediatr Surg Int 20:505–508
Kuwashima S, Nishimura G, Iimura F, Kohno T, Watanabe H, Kohno A, Fujioka M (2001) Low-intensity fetal lungs on MRI may suggest the diagnosis of pulmonary hypoplasia. Pediatr Radiol 31:669–672
Laje P, Martinez-Ferro M, Grisoni E, Dudgeon D (2006) Intraabdominal pulmonary sequestration. A case series and review of the literature. J Pediatr Surg 41:1309–1312
Laudy JA, Wladimiroff JW (2000) The fetal lung. 2: Pulmonary hypoplasia. Ultrasound Obstet Gynecol 16:482–494
Lauria MR, Gonik B, Romero R (1995) Pulmonary hypoplasia: pathogenesis, diagnosis, and antenatal prediction. Obstet Gynecol 86:466–475
Levine D, Jennings R, Barnewolt C, Mehta T, Wilson J, Wong G (2001) Progressive fetal bronchial obstruction caused by a bronchogenic cyst diagnosed using prenatal MR imaging. AJR Am J Roentgenol 176:49–52
Liu YP, Chen CP, Shih SL, Chen YF, Yang FS, Chen SC (2010) Fetal cystic lung lesions: evaluation with magnetic resonance imaging. Pediatr Pulmonol 45:592–600
Longaker MT, Laberge JM, Dansereau J, Langer JC, Crombleholme TM, Callen PW, Golbus MS, Harrison MR (1989) Primary fetal hydrothorax: natural history and management. J Pediatr Surg 24:573–576
Matsuoka S, Takeuchi K, Yamanaka Y, Kaji Y, Sugimura K, Maruo T (2003) Comparison of magnetic resonance imaging and ultrasonography in the prenatal diagnosis of congenital thoracic abnormalities. Fetal Diagn Ther 18:447–453
Moerman P, Fryns JP, Goddeeris P, Lauweryns JM (1982) Nonimmunologic hydrops fetalis. A study of ten cases. Arch Pathol Lab Med 106:635–640
Moessinger AC, Collins MH, Blanc WA, Rey HR, James LS (1986) Oligohydramnios-induced lung hypoplasia: the influence of timing and duration in gestation. Pediatr Res 20:951–954
Morotti RA, Cangiarella J, Gutierrez MC, Jagirdar J, Askin F, Singh G, Profitt SA, Wert SE, Whitsett JA, Greco MA (1999) Congenital cystic adenomatoid malformation of the lung (CCAM): evaluation of the cellular components. Hum Pathol 30:618–625
NICE Guideline I (2006) Insertion of pleuro-amniotic shunt for fetal pleural effusion. National Institute for Health and Clinical Excellence, London
Nishibayashi SW, Andrassy RJ, Woolley MM (1981) Congenital cystic adenomatoid malformation: a 30-year experience. J Pediatr Surg 16:704–706
Quinn TM, Hubbard AM, Adzick NS (1998) Prenatal magnetic resonance imaging enhances fetal diagnosis. J Pediatr Surg 33:553–558
Ribet ME, Copin MC, Gosselin B (1995) Bronchogenic cysts of the mediastinum. J Thorac Cardiovasc Surg 109:1003–1010
Rosado-de-Christenson ML, Stocker JT (1991) Congenital cystic adenomatoid malformation. Radiographics 11:865–886
Savic B, Birtel FJ, Knoche R, Tholen W, Schild H (1979a) Pulmonary sequestration. Ergeb Inn Med Kinderheilkd 43:57–92
Savic B, Birtel FJ, Tholen W, Funke HD, Knoche R (1979b) Lung sequestration: report of seven cases and review of 540 published cases. Thorax 34:96–101
Shanmugam G, MacArthur K, Pollock JC (2005) Congenital lung malformations – antenatal and postnatal evaluation and management. Eur J Cardiothorac Surg 27:45–52
Sherer DM, Davis JM, Woods JR Jr (1990) Pulmonary hypoplasia: a review. Obstet Gynecol Surv 45:792–803
Stocker JT (1986) Sequestrations of the lung. Semin Diagn Pathol 3:106–121
Stocker JT (2009) Cystic lung disease in infants and children. Fetal Pediatr Pathol 28:155–184
Stocker JT, Madewell JE, Drake RM (1977) Congenital cystic adenomatoid malformation of the lung. Classification and morphologic spectrum. Hum Pathol 8:155–171
Takeda S, Miyoshi S, Inoue M, Omori K, Okumura M, Yoon HE, Minami M, Matsuda H (1999) Clinical spectrum of congenital cystic disease of the lung in children. Eur J Cardiothorac Surg 15:11–17
Takeda S, Miyoshi S, Minami M, Ohta M, Masaoka A, Matsuda H (2003) Clinical spectrum of mediastinal cysts. Chest 124:125–132
Thorpe-Beeston JG, Nicolaides KH (1994) Cystic adenomatoid malformation of the lung: prenatal diagnosis and outcome. Prenat Diagn 14:677–688
van Teeffelen AS, van der Ham DP, Oei SG, Porath MM, Willekes C, Mol BW (2010) The accuracy of clinical parameters in the prediction of perinatal pulmonary hypoplasia secondary to midtrimester prelabour rupture of fetal membranes: a meta-analysis. Eur J Obstet Gynecol Reprod Biol 148:3–12
Wigglesworth JS, Desai R (1981) Use of DNA estimation for growth assessment in normal and hypoplastic fetal lungs. Arch Dis Child 56:601–605
Zeidan S, Hery G, Lacroix F, Gorincour G, Potier A, Dubus JC, Guys JM, de Lagausie P (2009) Intralobar sequestration associated with cystic adenomatoid malformation: diagnostic and thoracoscopic pitfalls. Surg Endosc 23:1750–1753
Zylak CJ, Eyler WR, Spizarny DL, Stone CH (2002) Developmental lung anomalies in the adult: radiologic-pathologic correlation. Radiographics 22 Spec No: S25–43
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Kasprian, G. (2010). MRI of the Pathological Fetal Thorax. In: Prayer, D. (eds) Fetal MRI. Medical Radiology(). Springer, Berlin, Heidelberg. https://doi.org/10.1007/174_2010_98
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DOI: https://doi.org/10.1007/174_2010_98
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