scholarly journals Computed tomography based measurements to evaluate lung density and lung growth after congenital diaphragmatic hernia

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Timm Stoll-Dannenhauer ◽  
Gregor Schwab ◽  
Katrin Zahn ◽  
Thomas Schaible ◽  
Lucas Wessel ◽  
...  
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Contralateral Side ◽  
Chest Ct ◽  
Control Group ◽  
P Value ◽  
Lung Density ◽  
Ipsilateral Lung ◽  
Contralateral Lung ◽  
Pediatric Chest

AbstractEmphysema-like-change of lung is one aspect of lung morbidity in children after congenital diaphragmatic hernia (CDH). This study aims to evaluate if the extent of reduced lung density can be quantified through pediatric chest CT examinations, if side differences are present and if emphysema-like tissue is more prominent after CDH than in controls. Thirty-seven chest CT scans of CDH patients (mean age 4.5 ± 4.0 years) were analyzed semi-automatically and compared to an age-matched control group. Emphysema-like-change was defined as areas of lung density lower than − 950 HU in percentage (low attenuating volume, LAV). A p-value lower than 0.05 was regarded as statistically significant. Hypoattenuating lung tissue was more frequently present in the ipsilateral lung than the contralateral side (LAV 12.6% vs. 5.7%; p < 0.0001). While neither ipsilateral nor contralateral lung volume differed between CDH and control (p > 0.05), LAV in ipsilateral (p = 0.0002), but not in contralateral lung (p = 0.54), was higher in CDH than control. It is feasible to quantify emphysema-like-change in pediatric patients after CDH. In the ipsilateral lung, low-density areas are much more frequently present both in comparison to contralateral and to controls. Especially the ratio of LAV ipsilateral/contralateral seems promising as a quantitative parameter in the follow-up after CDH.

scholarly journals The Role of the Fetal MRI to Predict the Postnatal Survival in Fetuses with Congenital Diaphragmatic Hernia

2021 ◽  
Author(s):  
Fatma Ceren Sarıoğlu ◽  
Orkun Sarıoğlu ◽  
İnci Türkan Yılmaz ◽  
Bahar Konuralp Atakul ◽  
Deniz Öztekin ◽  
...  
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Fetal Mri ◽  
Lung Parenchyma ◽  
P Value ◽  
Total Lung Volume ◽  
Ipsilateral Lung ◽  
Liver Herniation ◽  
Magnetic Resonance Imaging Mri

Objective: To assess the role of the magnetic resonance imaging (MRI) to predict the postnatal survival in patients with congenital diaphragmatic hernia (CDH). Method: 25 patients with CDH who had fetal MRI between 2015 and 2020 were enrolled in this retrospective study. Patients were divided into two groups according to the postnatal survival at 30 days of age: alive and dead. The fetal MRI images were assessed to calculate the lung-to-liver signal intensity ratio (LLSIR), and the total lung volume (TLV). In addition, the site of the defect (right or left), accompanying liver herniation (present or absent), detectable-ipsilateral lung parenchyma at the apex (present or absent) were also recorded. MRI images were evaluated by two pediatric radiologists. A p value lesser than 0.05 was considered statistically significant. Results: Among 25 fetuses, 6 were alive and 19 were dead within 30 days after birth. The detectable lung parenchyma had a relationship with the alive group (p = 0.023). Observed-to-expected TLV (p = 0.001) and LLSIR (p = 0.023) were significantly lower in the dead group. Using the cutoff values for the observed-to-expected TLV as 0.27 (a sensitivity of 84%, a specificity of 84%) and for the LLSIR as 2.02 (a sensitivity of 89%, a specificity of 67%) were found as predictors for death. Conclusion: The postnatal survival in CDH may be predicted using the observed-to-expected TLV and LLSIR on the fetal MRI. The presence of the detectable-ipsilateral lung parenchyma at the apex may also be associated with the postnatal survival.

Long-term medical and psychosocial outcomes in congenital diaphragmatic hernia survivors

2019 ◽  
Vol 104 (8) ◽  
pp. 761-767 ◽  
Author(s):  
Jason K Tan ◽  
Georgia Banton ◽  
Corrado Minutillo ◽  
Graham L Hall ◽  
Andrew Wilson ◽  
...  
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Chest Ct ◽  
Lung Mechanics ◽  
Control Group ◽  
Architectural Distortion ◽  
Forced Oscillation Technique ◽  
Z Score

ObjectiveSurvival rates for congenital diaphragmatic hernia (CDH) are increasing. The long-term outcomes of CDH survivors were compared with a healthy control group to assess the morbidity for guidance of antenatal counselling and long-term follow-up programmes.Participants and designParticipants born with CDH in Western Australia 1993–2008 were eligible with matched controls from the general population. Participants had comprehensive lung function tests, echocardiogram, low-dose chest CT scan and completed a Strengths and Difficulties Questionnaire (SDQ) and quality of life (QOL) questionnaire.Results34 matched case–control pairs were recruited. Demographic data between groups were similar. Cases were smaller at follow-up (weight Z-score of −0.2vs0.3; p=0.03; height Z-score of −0.3vs0.6; p=0.01). Cases had lower mean Z-scores for forced expiratory volume in 1 s (FEV1) (−1.49 vs −0.01; p=0.004), FEV1/forced vital capacity (−1.92 vs −1.2; p=0.009) and forced expiratory flow at 25-75% (FEF25-75) (−1.18vs0.23; p=0.007). Cases had significantly worse respiratory mechanics using forced oscillation technique. Subpleural triangles architectural distortion, linear opacities and scoliosis on chest CT were significantly higher in cases. Prosthetic patch requirement was associated with worse lung mechanics and peak cough flow. Cases had significantly higher rates of gastro-oesophageal reflux disease (GORD) and GORD medication usage. Developmental delay was significantly higher in cases. More cases had a total difficulties score in the high to very high range (25% vs 0%, p=0.03) on the SDQ and reported lower objective QOL scores (70.2 vs 79.8, p=0.02).ConclusionSurvivors of CDH may have significant adverse long-term medical and psychosocial issues that would be better recognised and managed in a multidisciplinary clinic.

Diaphragmatic Hernia

1996 ◽  
Vol 17 (3) ◽  
pp. 102-102
Author(s):  
Anne Marie Cairns ◽  
Jeffrey M. Ewig
Keyword(s):  
Embryonic Development ◽  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Morphometric Analysis ◽  
Surgical Repair ◽  
Ipsilateral Lung ◽  
Contralateral Lung ◽  
Mediastinal Shift ◽  
Severe Reduction

Congenital diaphragmatic hernia (CDH), with an incidence of approximately 1 in 3000 births, occurs secondary to defective fusion of the pleuroperitoneal membranes during embryonic development. The most common form is the posterolateral hernia through the foramen of Bochdalek, with a left-to-right ratio of approximately 8:1. The space-occupying effect of the bowel during pulmonary development results in hypoplasia of the ipsilateral lung. This process also may cause hypoplasia to a lesser degree of the contralateral lung, secondary to severe mediastinal shift. Bohn and co-workers assessed alveolar number by postmortem morphometric analysis of five infants who died after surgical repair for CDH. A severe reduction in alveolar number was noted in both the ipsilateral and contralateral lung, although the changes in the ipsilateral lung were more pronounced.

Three-dimensional sonographic measurement of contralateral lung volume in fetuses with isolated congenital diaphragmatic hernia

2008 ◽  
Vol 36 (5) ◽  
pp. 273-278 ◽  
Author(s):  
Rodrigo Ruano ◽  
Marie-Cécile Aubry ◽  
Bruno Barthe ◽  
Yves Dumez ◽  
Marcelo Zugaib ◽  
...  
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Lung Volume ◽  
Three Dimensional ◽  
Contralateral Lung

The use of chest CT scan in evaluation of structural lung sequelae in congenital diaphragmatic hernia survivors

2017 ◽  
Author(s):  
Marijke Proesmans ◽  
Emma Beel ◽  
Stein Magnus Aukland ◽  
Mieke Boon ◽  
Francois Vermeulen ◽  
...  
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Ct Scan ◽  
Diaphragmatic Hernia ◽  
Chest Ct ◽  
Chest Ct Scan

scholarly journals MR lung perfusion measurements in adolescents after congenital diaphragmatic hernia: correlation with spirometric lung function tests

2021 ◽  
Author(s):  
Verena Groß ◽  
Katrin Zahn ◽  
Kristina Maurer ◽  
Lucas Wessel ◽  
Thomas Schaible ◽  
...  
Keyword(s):  
Blood Flow ◽  
Lung Function ◽  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Pulmonary Blood Flow ◽  
Lung Perfusion ◽  
Control Group ◽  
Lung Function Tests ◽  
Function Tests ◽  
Perfusion Measurements

Abstract Objectives To evaluate whether lung perfusion continues to be reduced in 10-year-old children after congenital diaphragmatic hernia (CDH) and whether lung perfusion values correlate with spirometric lung function measurements. Methods Fifty-four patients after CDH repair received dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI)-based lung perfusion measurements at the age of 10 years (10.2 ± 1.0 years). Additionally, a control group of 10 children has been examined according to the same protocol. Lung spirometry was additionally available in 43 patients of the CDH group. A comparison of ipsilateral and contralateral parameters was performed. Results Pulmonary blood flow (PBF) was reduced on the ipsilateral side in CDH patients (60.4 ± 23.8 vs. 93.3 ± 16.09 mL/100 mL/min; p < 0.0001). In comparison to the control group, especially the ratio of ipsilateral to contralateral, PBF was reduced in CDH patients (0.669 ± 0.152 vs. 0.975 ± 0.091; p < 0.0001). There is a positive correlation between ipsilateral pulmonary blood flow, and spirometric forced 1-s volume (r = 0.45; p = 0.0024). Conclusions Pulmonary blood flow impairment persists during childhood and correlates with spirometric measurements. Without the need for ionizing radiation, MRI measurements seem promising as follow-up parameters after CDH. Key Points • Ten-year-old children after congenital diaphragmatic hernia continue to show reduced perfusion of ipsilateral lung. • Lung perfusion values correlate with lung function tests after congenital diaphragmatic hernia.

Vitamin A decreases the incidence and severity of nitrofen-induced congenital diaphragmatic hernia in rats

1999 ◽  
Vol 277 (2) ◽  
pp. L423-L429 ◽  
Author(s):  
Bernard Thébaud ◽  
Dick Tibboel ◽  
Caroline Rambaud ◽  
Jean-Christophe Mercier ◽  
Jacques R. Bourbon ◽  
...  
Keyword(s):  
Vitamin A ◽  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Weight Ratio ◽  
Treated Group ◽  
Control Group ◽  
Lung Growth ◽  
Body Weight Ratio ◽  
Pregnant Rats ◽  
Antenatal Treatment

Congenital diaphragmatic hernia (CDH) is a major cause of refractory respiratory failure in the newborn. Pulmonary hypoplasia often limits survival. Vitamin A (Vit A) is an important signal for lung growth. We hypothesized that antenatal treatment with Vit A would stimulate lung growth and decrease mortality in experimental CDH induced in rats by ingestion of the herbicide nitrofen (2,4-dichlorophenyl- p-nitrophenyl ether). Nitrofen was administered to pregnant rats on day 12 of gestation (term 22 days). Rats were assigned to five groups: three groups received one dose of oral antenatal Vit A (15,000 IU) before ( day 10), concomitant with ( day 12), or after ( day 14) nitrofen administration; one group received only nitrofen; and a control group received vehicle (olive oil). The incidence of CDH was markedly lower in all groups receiving Vit A ( day 10, 44%; day 12, 20%; and day 14, 40%) compared with the nitrofen-treated group (84%; P < 0.05). The 72-h survival was higher in all 3 Vit A-treated groups ( day 10, 40%; day 12, 58%; and day 14, 70%) compared with the nitrofen-treated group (16%; P< 0.05). Lung-to-body weight ratio and radial saccular count were significantly increased by Vit A. Antenatal treatment with Vit A lowers the incidence and severity of experimental CDH and increases lung growth and maturation.

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