Article

Fetal tracheolaryngeal airway obstruction: prenatal evaluation by sonography and MRI. Pediatr Radiol

Department of Radiology, University of California San Francisco, Box 0628, M-372, 505 Parnassus Ave., San Francisco, CA 94143-0628, USA.
Pediatric Radiology (Impact Factor: 1.65). 11/2010; 40(11):1800-5. DOI: 10.1007/s00247-010-1800-x
Source: PubMed

ABSTRACT We reviewed the sonographic and MRI findings of tracheolaryngeal obstruction in the fetus. Conditions that can cause tracheolaryngeal obstruction include extrinsic causes such as lymphatic malformation, cervical teratoma and vascular rings and intrinsic causes such as congenital high airway obstruction syndrome (CHAOS). Accurate distinction of these conditions by sonography or MRI can help facilitate parental counseling and management, including the decision to utilize the ex utero intrapartum treatment (EXIT) procedure.

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    • "Fetal ascites and nonimmune hydrops may also be associated with the clinical condition [3]. Due to the recently described management options, prenatal definition of fetal airway obstruction has come into prominence with the hope of neonatal outcome improvements [4]. We report here two cases of CHAOS due to tracheal atresia diagnosed by antenatal ultrasonography and fetal MRI. "
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    ABSTRACT: Congenital high airway obstruction syndrome (CHAOS) is the obstruction of the fetal upper airways, which may be partial or complete. It is usually incompatible with life. Prenatal recognition of the disease is quite important due to the recently described management options. We report here two cases of CHAOS due to tracheal atresia diagnosed by antenatal ultrasonography and fetal MRI. We also briefly review the relevant literature with the associated management options.
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    ABSTRACT: The radiologist plays a key role in the diagnosis of airway obstruction in children. In some instances, foetal imaging has significantly contributed to our understanding of congenital lesions, their natural history, and the effects of airway obstruction. In infants and young children, diagnosis, and obstruction site and severity are frequently determined by chest radiographs or airway images. Advanced imaging techniques with computed tomography (CT) and magnetic resonance (MR) play a role in children with chronic upper airway compromise or who are suspected of having extrinsic airway compression by a mass or vascular arch anomaly. Technical advances with faster scanners with gating utilising CT and MR with sophisticated postprocessing graphic workstations has made it much easier for both the radiologists and clinical services to understand the anatomy.
    12/2010: pages 243-248;
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