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Fetale Magnetresonanztomographie

Diagnostik bei kongenitaler Zwerchfellhernie

Fetal magnetic resonance imaging

Diagnostics in congenital diaphragmatic hernia

  • Fetale MRT
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Zusammenfassung

Der Ultraschall dient in der Schwangerschaft routinemäßig als Screeningmethode für fetale und maternale Anomalien, da dieser als sicher für Kind und Mutter, günstig, allseits verfügbar gilt und die Möglichkeit einer Real-time-Darstellung bietet. Insbesondere aufgrund der Weiterentwicklung in den letzten 10–15 Jahren verfügt der Ultraschall über eine hohe Aussagekraft bzgl. fetaler Fehlbildungen. In einzelnen Fällen, z. B. bei komplexen Fehlbildungen, kann die Magnetresonanztomographie (MRT) suffiziente Zusatzinformationen liefern. Aus diesem Grund hat sich die fetale MRT zur Diagnostik fetaler Fehlbildungen bewährt. Die Diagnose einer kongenitalen Zwerchfellhernie (congenital diaphragmatic hernia, CDH) kann im Ultraschall gerade durch sonographische Ähnlichkeit von Leber und Lunge erschwert sein. Im Falle einer CDH bietet die MRT neben der reinen Morphologie, u. a. der Ausdehnung der nach intrathorakal hernierten Abdominalorgane, die Beurteilung des komprimierten Lungenparenchyms. Die Möglichkeit der fetalen Lungenvolumetrie in der MRT ermöglicht die pränatale Risikoabschätzung und darauf basierend die Planung des peri- und postnatalen Managements zur Verbesserung des postnatalen Verlaufs.

Abstract

Ultrasonography is the primary imaging modality for the evaluation of fetal or maternal anomalies. This method is safe, relatively inexpensive, easily accessible, and allows real-time imaging. Continuous technical improvements in ultrasonography in the last 10–15 years have led to improved diagnostic accuracy for fetal malformations. In cases of complex anomalies magnetic resonance imaging (MRI) can provide additional information. MRI has evolved as a valuable diagnostic method for evaluating fetal pathology. Particularly with regard to similarity of liver and lung parenchyma in ultrasonography, diagnosis of congenital diaphragmatic hernia (CDH) can be difficult. Beside morphological aspects, e.g., herniation of abdominal contents into the chest, small amounts of compressed lung can be visualized on MRI. The feasibility of using volumetric measurement on MRI may be helpful to predict high-risk fetuses and facilitate decisions to assure adequate prenatal and postnatal management to improve postnatal outcome.

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  1. Institut für Klinische Radiologie, Universitätsklinikum Mannheim, Fakultät für Klinische Medizin der Universität Heidelberg

    A. K. Kilian, K. A. Büsing & K. W. Neff

  2. Kinderklinik, Universitätsklinikum Mannheim, Fakultät für Klinische Medizin der Universität Heidelberg

    T. Schaible

  3. Institut für Klinische Radiologie, Universitätsklinikum Mannheim, Fakultät für Klinische Medizin der Universität Heidelberg, Theodor-Kutzer-Ufer 1–3, 68167, Mannheim

    A. K. Kilian

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  1. A. K. Kilian
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  2. K. A. Büsing
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  3. T. Schaible
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  4. K. W. Neff
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Correspondence to A. K. Kilian.

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Kilian, A.K., Büsing, K.A., Schaible, T. et al. Fetale Magnetresonanztomographie. Radiologe 46, 128–132 (2006). https://doi.org/10.1007/s00117-005-1319-6

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  • DOI: https://doi.org/10.1007/s00117-005-1319-6

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