Related Experiment Video
Updated: May 15, 2026
Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus
Published on: March 6, 2019
Space occupying lesions in the fetal chest evaluated by MRI
Umit Aksoy Ozcan1, Ersan Altun, Latif Abbasoglu
1Department of Radiology, School of Medicine, Acibadem University, Istanbul, Turkey.
Background:
The most common space occupying lesions of the fetal thorax are congenital diaphragmatic hernia (CDH), congenital cystic adenomatoid malformation (CCAM), and bronchopulmonary sequestration (BPS). Although applications of prenatal MRI have been vastly improved in the recent years, its use in the assessment of space occupying lesions of the fetal chest differs among centers.
Objectives:
To evaluate MRI findings in the diagnosis and follow-up of space-occupying lesions in the fetal chest with the review of relevant literature.
Patients And Methods:
The fetuses with space-occupying lesions of the chest were retrieved from our 1.5T fetal MRI database of 347 patients. MRI features including the shape, signal characteristics, feeding artery, margin, mass effect, affected organ parts and anatomic location were reviewed. The results were correlated with the pathology results, follow-up and surgical findings.
Results:
Nineteen MR images of 17 fetuses (mean gestational age, 23.8 weeks) with spaceoccupying lesions (5 CCAMs including one involuted case), 2 BPSs, 2 hybrid lesions, 8 CDH) were evaluated. One case of CCAM completely involuted in utero, four newborns were operated, and the resulting 12 fetuses were terminated. The surgical and pathological findings were in accordance with MRI findings.
Conclusion:
MRI can reliably differentiate CDH from CCAM and BPS in utero. Follow-up is of utmost importance as lesions may involute or progress in utero. Prenatal MRI findings help postnatal decision-making, surgical planning and parental counseling.
Insights
Prenatal MRI accurately diagnoses fetal chest masses like congenital diaphragmatic hernia (CDH), congenital cystic adenomatoid malformation (CCAM), and bronchopulmonary sequestration (BPS). Close follow-up is crucial as these lesions can change in utero.
Area of Science:
- Medical imaging
- Fetal medicine
- Pediatric surgery
Background:
- Congenital diaphragmatic hernia (CDH), congenital cystic adenomatoid malformation (CCAM), and bronchopulmonary sequestration (BPS) are common fetal thoracic space-occupying lesions.
- Prenatal MRI applications for fetal chest lesions vary in clinical practice.
Purpose of the Study:
- To evaluate MRI findings for diagnosing and monitoring fetal chest space-occupying lesions.
- To correlate MRI findings with literature on these conditions.
Main Methods:
- Retrospective review of 1.5T fetal MRI scans from 347 patients.
- Analysis of MRI features: shape, signal, feeding artery, margins, mass effect, affected organs, location.
- Correlation of MRI findings with pathology, follow-up, and surgical outcomes.
Main Results:
- Evaluated 19 MRIs of 17 fetuses (mean gestational age 23.8 weeks) with CDH (8), CCAM (5, including 1 involuted), BPS (2), and hybrid lesions (2).
- One CCAM case involuted in utero; 4 neonates underwent surgery.
- MRI findings correlated well with surgical and pathological results.
Conclusions:
- Prenatal MRI reliably distinguishes CDH from CCAM and BPS.
- In utero lesion evolution (involutio or progression) necessitates diligent follow-up.
- Prenatal MRI aids in postnatal decision-making, surgical planning, and parental counseling.
Related Concept Videos
01:30Radiological Investigation II: MRI and Ventilation Perfusion Scan
Magnetic Resonance Imaging (MRI) and Ventilation Perfusion Scans are two radiological investigations that offer detailed diagnostic images of the body, particularly lung structures.
MRI
MRI uses magnetic fields and radiofrequency signals to distinguish between normal and abnormal tissues. This technology provides a more detailed diagnostic image than CT scans, enabling it to characterize pulmonary nodules, stage bronchogenic carcinoma, and evaluate inflammatory activity in...
01:20Imaging Studies for Cardiovascular System III: X-Ray
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...