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Current advances in prenatal imaging of congenital diaphragmatic [corrected] hernia
1Department of Radiology, Fetal Care Center of Cincinnati, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA. beth.kline-fath@cchmc.org
Insights
Congenital diaphragmatic hernia (CDH) is complex, with outcomes improved by prenatal imaging. Further research in prenatal ultrasound and fetal MRI is crucial for reducing CDH morbidity and mortality.
Area of Science:
- Pediatric Surgery
- Fetal Medicine
- Medical Imaging
Background:
- Congenital diaphragmatic hernia (CDH) presents significant challenges in survival due to associated pulmonary hypoplasia and hypertension.
- Despite therapeutic advancements, the exact etiology of CDH remains elusive, necessitating improved understanding and management strategies.
Purpose of the Study:
- To explore the role of prenatal imaging in understanding congenital diaphragmatic hernia.
- To evaluate measurement techniques used with prenatal ultrasound (US) and fetal magnetic resonance imaging (MRI) for prognosticating CDH complications.
- To highlight the need for standardized approaches in prenatal imaging for CDH.
Main Methods:
- Review of current literature on prenatal diagnostic modalities for CDH.
- Analysis of measurement techniques employed in prenatal US and fetal MRI for assessing pulmonary development.
- Discussion of variability in imaging protocols across different centers.
Main Results:
- Prenatal US and fetal MRI have enhanced the understanding of CDH.
- Measurement techniques derived from these imaging modalities serve as prognosticators for pulmonary hypoplasia and hypertension.
- Significant variability exists in measurement approaches among imaging centers.
Conclusions:
- Standardization of prenatal US and fetal MRI measurement techniques is needed to improve prognostic accuracy for CDH.
- Continued research and development of innovative therapies are essential for reducing CDH-related morbidity and mortality.
- Improved prenatal assessment is foundational for effective counseling and therapeutic planning in CDH cases.
Abstract:
Congenital diaphragmatic hernia, despite advances in therapy, remains a complex condition with significant morbidity and mortality. The etiology of the disorder is still incompletely understood, though the pulmonary hypoplasia and pulmonary hypertension that develop secondarily must be overcome to improve survival. Prenatal US and fetal MRI have helped in the development of a greater understanding of this disease. Also with these modalities, measurement techniques have been developed in an attempt to provide prognosticators for the development of pulmonary hypoplasia and pulmonary hypertension. There is a broad range of approaches for performing these measurements, and variability among imaging centers is noted. Despite inconsistent approaches, these techniques have become the foundation for counseling and prenatal and postnatal therapy. It is hoped that with further research with prenatal US and fetal MRI and the development of innovative medical and surgical therapies that the morbidity and mortality of children with congenital diaphragmatic hernias can be significantly reduced.
