The Benefits of MRI in the Prenatal Diagnosis of Congenital Diaphragmatic Hernia

Abstract

Aims: We searched for correlations between ultrasound findings in pregnancies with congenital diaphragmatic hernia (CDH) and magnetic resonance imaging (MRI) follow-up examinations; MRI was used to confirm and complete the investigation in these difficult cases. In some of them, new elements that ultrasound was not able to fully describe have been also brought. We were especially interested when MRI was superior to ultrasound. Material and methods: This is a retrospective study of 12 pregnancies with congenital diaphragmatic hernia that were diagnosed in two major university clinics of Bucharest, Romania. Ultrasounds and MRI examinations were performed to evaluate pulmonary hypoplasia and correctly asses the herniated organs. We used standard international protocols and guidelines for calculating different parameters. All patients signed an informed consent before being enrolled in the study. Results: We described the herniated organs, dimensions of the hernia and the remaining lung capacity, so that we could correctly evaluate the prognosis. We have also used the lung to head ratio (LHR) in an attempt to better determine the degree of lung hypoplasia. Conclusions: High quality ultrasound followed by an MRI examination helped correctly assess the prognostic, treatment possibilities and total affected lung volume. It not only confirmed the diagnosis, but also offered new information that ultrasound was not able to provide.