To compare MRI-based functional pulmonary and cardiac measurements in the long-term follow-up of children operated on for left-sided congenital diaphragmatic hernia (CDH) with age- and body size-matched healthy controls.
Twelve children who received immediate postnatal surgery for closure of isolated left-sided CDH were included and received basic medical examinations, pulmonary function testing and echocardiography. MRI included measurement of lung volume, ventricular function assessment and velocity-encoded imaging of the pulmonary arteries and was compared with the data for 12 healthy children matched for age and body size.
While patients' clinical test results were not suspicious, comparison between the MRI data for patients and those for healthy controls revealed significant differences. In patients, the volumes of the left lungs were increased and the tidal volume was larger on the right side. While the stroke volumes of both ventricles were reduced, heart rate and ejection fraction were increased. Flow, acceleration time and cross-sectional area of the left pulmonary artery were reduced.
Functional MRI detected pulmonary and cardiac findings in the late follow-up of CDH children which may be missed by standard clinical methods and might be relevant for decisions regarding late outcome and treatment.
European Radiology 02/2010; 20(7):1580-9. DOI:10.1007/s00330-010-1723-9 · 4.34 Impact Factor
RöFo - Fortschritte auf dem Gebiet der R 01/2008; 180. DOI:10.1055/s-2008-1073796 · 1.96 Impact Factor
To compare lung volumes and pulmonary arterial flow of children operated for diaphragmatic hernia with age-matched healthy subjects.
METHOD AND MATERIALS
Twelve children (median age: 12 years, range 6-18 years) who received immediate postnatal surgery for closure of isolated diaphragmatic hernias were examined at a 1.5T MRI. Imaging consisted of real-time volumetric acquisition of the entire lungs during free breathing and flow measurements of both pulmonary arteries. Bilateral lung volumes and flow data was compared with 12 age- and sex-matched healthy children.
Mean proportional expiratory lung volumes were 50% right / 50% left in patients and 56% right / 44% left in probands. Differences between patients and probands were significant (p=0.03). Volume flow analyses in patients: left pulmonary artery (2.1 l/min, 43%), right pulmonary artery (2.8 l/min, 57%); in probands: left pulmonary artery (2.6 l/min, 47%), right pulmonary artery (3.0 l/min, 53%). Differences between patients and probands were not significant (p=0.2).
While lung volumes revealed a side related difference between patients and probands, the lung flow showed no differences.
MRI might be useful for the detection of side related differences in expiratory volumes of patients after surgery of diaphragmatic hernia.
Radiological Society of North America 2007 Scientific Assembly and Annual Meeting; 11/2007