Related Experiment Video
Updated: Aug 13, 2026
Transuterine Fetal Tracheal Occlusion Model in Mice
Published on: February 5, 2021
Fetal MRI in experimental tracheal occlusion
Ulrike Wedegärtner1, Hobe J Schröder, Gerhard Adam
1Department of Diagnostic and Interventional Radiology, Universitätsklinikum Hamburg-Eppendorf, Martinistrasse 52, 20251 Hamburg, Germany. wedegaer@uke.uni-hamburg.de
Insights
Prenatal tracheal occlusion (TO) can reverse pulmonary hypoplasia in fetuses with congenital diaphragmatic hernia (CDH), improving lung growth. Both MRI and ultrasound are valuable for monitoring fetal lung development after TO.
Area of Science:
- Fetal Medicine
- Pediatric Surgery
- Medical Imaging
Background:
- Congenital diaphragmatic hernia (CDH) is a severe condition with high mortality, primarily due to pulmonary hypoplasia and pulmonary hypertension.
- Prenatal tracheal occlusion (TO) is a surgical intervention to promote lung growth in fetuses with severe CDH.
- Accurate prenatal diagnosis and monitoring are crucial for identifying high-risk fetuses and assessing the effectiveness of TO.
Purpose of the Study:
- To evaluate the role of prenatal imaging in identifying fetuses with CDH who would benefit from TO.
- To assess the utility of ultrasound (US) and magnetic resonance imaging (MRI) in monitoring fetal lung growth after TO.
- To compare the diagnostic capabilities of US and MRI in evaluating CDH and its associated lung hypoplasia.
Main Methods:
- Review of prenatal imaging techniques, including ultrasound (US) and magnetic resonance imaging (MRI), for CDH assessment.
- Discussion of the limitations of US and the advantages of MRI in evaluating liver herniation and lung volumes.
- Assessment of fetal lung growth in sheep models using cross-sectional US measurements following initial MRI lung volume determination.
Main Results:
- Ultrasound is the primary imaging modality for CDH due to its availability and cost-effectiveness.
- MRI offers superior tissue contrast, aiding in the diagnosis of high-risk CDH fetuses by evaluating liver herniation and determining absolute lung volumes.
- Both MRI and US were found to be useful in monitoring fetal lung growth after prenatal TO in a sheep model.
Conclusions:
- Prenatal imaging, particularly MRI, is essential for identifying fetuses with CDH who may benefit from TO.
- Combined use of MRI and US can effectively monitor fetal lung development and the impact of TO.
- These imaging modalities are critical for optimizing management strategies in fetuses diagnosed with CDH.
Abstract:
Congenital diaphragmatic hernia (CDH) is associated with a high mortality, which is mainly due to pulmonary hypoplasia and secondary pulmonary hypertension. In severely affected fetuses, tracheal occlusion (TO) is performed prenatally to reverse pulmonary hypoplasia, because TO leads to accelerated lung growth. Prenatal imaging is important to identify fetuses with pulmonary hypoplasia, to diagnose high-risk fetuses who would benefit from TO, and to monitor the effect of TO after surgery. In fetal imaging, ultrasound (US) is the method of choice, because it is widely available, less expensive, and less time-consuming to perform than magnetic resonance imaging (MRI). However, there are some limitations for US in the evaluation of CDH fetuses. In those cases, MRI is helpful because of a better tissue contrast between liver and lung, which enables evaluation of liver herniation for the diagnosis of a high-risk fetus. MRI provides the ability to determine absolute lung volumes to detect lung hypoplasia. In fetal sheep with normal and hyperplastic lungs after TO, lung growth was assessed on the basis of cross-sectional US measurements, after initial lung volume determination by MRI. To monitor fetal lung growth after prenatal TO, both MRI and US seem to be useful methods.
