European Radiology

, Volume 20, Issue 4, pp 829–837 | Cite as

Assessment of lung development in isolated congenital diaphragmatic hernia using signal intensity ratios on fetal MR imaging

  • Csilla BalassyEmail author
  • Gregor Kasprian
  • Peter C. Brugger
  • Michael Weber
  • Bence Csapo
  • Christian Herold
  • Daniela Prayer



To investigate developmental changes in the apparently unaffected contralateral lung by using signal intensity ratios (SIR) and lung volumes (LV), and to search for correlation with clinical outcome.


Twenty-five fetuses (22–37 weeks’ gestation) were examined. Lung/liver signal intensity ratios (LLSIR) were assessed on T1-weighted and T2-weighted sequences for both lungs, then together with LV compared with age-matched controls of 91 fetuses by using the U test. Differences in LLSIRs and lung volumes were correlated with neonatal outcomes.


LLSIRs in fetuses with congenital diaphragmatic hernia (CDH) were significantly higher in both lungs on T1-weighted images and significantly lower on T2-weighted images, compared with normals (p < 0.05), increasing on T2-weighted imaging and decreasing on T1-weighted imaging during gestation. Total LV were significantly smaller in the CDH group than in controls (p < 0.05). No significant differences in LLSIR of the two lungs were found. Outcomes correlated significantly with total LV, but not with LLSIR.


Changes in LLSIR seem to reflect developmental impairment in CDH; however, they provide no additional information in predicting outcome. LV remains the best indicator on fetal MR imaging of neonatal survival in isolated, left-sided CDH.


Fetal MR imaging Signal intensities Congenital diaphragmatic hernia Fetal lung Structural changes 


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Copyright information

© European Society of Radiology 2009

Authors and Affiliations

  • Csilla Balassy
    • 1
    Email author
  • Gregor Kasprian
    • 1
  • Peter C. Brugger
    • 2
  • Michael Weber
    • 1
  • Bence Csapo
    • 3
  • Christian Herold
    • 1
  • Daniela Prayer
    • 1
  1. 1.Department of RadiologyMedical University of ViennaViennaAustria
  2. 2.Centre of Anatomy and Cell BiologyMedical University of ViennaViennaAustria
  3. 3.Department of Obstetrics and GyneocologyMedical University of ViennaViennaAustria

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