Skip to main content
Log in

Kongenitale Zwerchfellhernie

Bildgebung von der Diagnose bis zur Nachsorge

Congenital diaphragmatic hernia

Imaging—from diagnosis to aftercare

  • Leitthema
  • Published:
Die Radiologie Aims and scope Submit manuscript

Zusammenfassung

Radiologische Standardverfahren

Fetal: Ultraschall und Magnetresonanztomographie (MRT), postnatal: konventionelle Röntgendiagnostik, Computertomographie (CT) und MRT.

Methodische Innovationen

MRT-basierte Lungenventilations- und Perfusionsmessung

Empfehlung für die Praxis

Es sollte eine lebenslange Nachsorge erfolgen, bei der sich die Radiologie als Teil des Behandlungsteams versteht.

Abstract

Standard radiological methods

Fetal: Ultrasound and magnetic resonance imaging (MRI); postnatal: conventional X‑ray diagnostics, computed tomography (CT) and MRI.

Methodical innovations

MRI-based lung ventilation and perfusion measurement.

Practical recommendations

Lifelong follow-up care should be provided, in which radiology is part of the treatment team.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Abb. 1
Abb. 2
Abb. 3
Abb. 4
Abb. 5

Literatur

  1. Beel E, Aukland SM, Boon M et al (2020) Chest CT scoring for evaluation of lung sequelae in congenital diaphragmatic hernia survivors. Pediatr Pulmonol 55:740–746

    Article  PubMed  Google Scholar 

  2. Bjorkman KC, Kjellberg M, Bergstrom SE et al (2011) Postoperative regional distribution of pulmonary ventilation and perfusion in infants with congenital diaphragmatic hernia. J Pediatr Surg 46:2047–2053

    Article  PubMed  Google Scholar 

  3. Costlow RD, Manson JM (1981) The heart and diaphragm: target organs in the neonatal death induced by nitrofen (2,4-dichlorophenyl-p-nitrophenyl ether). Toxicology 20:209–227

    Article  CAS  PubMed  Google Scholar 

  4. Deprest JA, Nicolaides KH, Benachi A et al (2021) Randomized trial of fetal surgery for severe left diaphragmatic hernia. N Engl J Med 385:107–118

    Article  PubMed  PubMed Central  Google Scholar 

  5. Dütemeyer V, Schaible T, Badr DA et al (2023) Fetoscopic endoluminal tracheal occlusion versus expectant management for fetuses with severe left-sided congenital diaphragmatic hernia. Am J Obstet Gynecol MFM:101248

    Google Scholar 

  6. Gross V, Zahn K, Maurer K et al (2021) MR lung perfusion measurements in adolescents after congenital diaphragmatic hernia: correlation with spirometric lung function tests. Eur Radiol

  7. Hayward MJ, Kharasch V, Sheils C et al (2007) Predicting inadequate long-term lung development in children with congenital diaphragmatic hernia: an analysis of longitudinal changes in ventilation and perfusion. J Pediatr Surg 42:112–116

    Article  PubMed  Google Scholar 

  8. Hirsch FW, Sorge I, Vogel-Claussen J et al (2020) The current status and further prospects for lung magnetic resonance imaging in pediatric radiology. Pediatr Radiol 50:734–749

    Article  PubMed  PubMed Central  Google Scholar 

  9. Hollinger LE, Buchmiller TL (2020) Long term follow-up in congenital diaphragmatic hernia. Seminars Perinatol 44:151171

    Article  Google Scholar 

  10. Ilicak E, Thater G, Ozdemir S et al (2023) Functional lung imaging of 2‑year-old children after congenital diaphragmatic hernia repair using dynamic mode decomposition MRI. Eur Radiol

  11. Jani J, Nicolaides KH, Keller RL et al (2007) Observed to expected lung area to head circumference ratio in the prediction of survival in fetuses with isolated diaphragmatic hernia. Ultrasound Obstet Gynecol 30:67–71

    Article  CAS  PubMed  Google Scholar 

  12. Keijzer R, Liu J, Deimling J et al (2000) Dual-hit hypothesis explains pulmonary hypoplasia in the nitrofen model of congenital diaphragmatic hernia. Am J Pathol 156:1299–1306

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Klaassens M, De Klein A, Tibboel D (2009) The etiology of congenital diaphragmatic hernia: still largely unknown? Eur J Med Genet 52:281–286

    Article  CAS  PubMed  Google Scholar 

  14. Lally KP, Engle W (2008) Postdischarge follow-up of infants with congenital diaphragmatic hernia. Pediatrics 121:627–632

    Article  PubMed  Google Scholar 

  15. Machado-Rivas F, Choi JJ, Alejandra Bedoya M et al (2023) Brain growth in fetuses with congenital diaphragmatic hernia. J Neuroimaging 33:617–624

    Article  PubMed  Google Scholar 

  16. Metkus AP, Filly RA, Stringer MD et al (1996) Sonographic predictors of survival in fetal diaphragmatic hernia. J Pediatr Surg 31:148–151

    Article  CAS  PubMed  Google Scholar 

  17. Mullassery D, Ba’ath ME, Jesudason EC et al (2010) Value of liver herniation in prediction of outcome in fetal congenital diaphragmatic hernia: a systematic review and meta-analysis. Ultrasound Obstet Gynecol 35:609–614

    Article  CAS  PubMed  Google Scholar 

  18. Paek BW, Coakley FV, Lu Y et al (2001) Congenital diaphragmatic hernia: prenatal evaluation with MR lung volumetry—preliminary experience. Radiology 220:63–67

    Article  CAS  PubMed  Google Scholar 

  19. Peralta CF, Cavoretto P, Csapo B et al (2005) Assessment of lung area in normal fetuses at 12–32 weeks. Ultrasound Obstet Gynecol 26:718–724

    Article  CAS  PubMed  Google Scholar 

  20. Radhakrishnan R, Merhar SL, Burns P et al (2019) Fetal brain morphometry on prenatal magnetic resonance imaging in congenital diaphragmatic hernia. Pediatr Radiol 49:217–223

    Article  PubMed  Google Scholar 

  21. Rypens F, Metens T, Rocourt N et al (2001) Fetal lung volume: estimation at MR imaging-initial results. Radiology 219:236–241

    Article  CAS  PubMed  Google Scholar 

  22. Shah NR, Criss CN, Burgi K et al (2023) Thoracoscopic patch repair of congenital diaphragmatic hernia: can smaller incisions treat larger defects? J Pediatr Surg

  23. Shieh HF, Barnewolt CE, Wilson JM et al (2017) Percent predicted lung volume changes on fetal magnetic resonance imaging throughout gestation in congenital diaphragmatic hernia. J Pediatr Surg 52:933–937

    Article  PubMed  Google Scholar 

  24. Short HL, Clifton MS, Arps K et al (2018) The “Flat diaphragm”: does the degree of curvature of the diaphragm on postoperative X‑Ray predict congenital diaphragmatic hernia recurrence? J Laparoendosc Adv Surg Tech A 28:476–480

    Article  PubMed  Google Scholar 

  25. Snoek KG, Reiss IK, Greenough A et al (2016) Standardized postnatal management of infants with congenital diaphragmatic hernia in Europe: the CDH EURO consortium consensus—2015 update. Neonatology 110:66–74

    Article  PubMed  Google Scholar 

  26. Stefanutti G, Filippone M, Tommasoni N et al (2004) Cardiopulmonary anatomy and function in long-term survivors of mild to moderate congenital diaphragmatic hernia. J Pediatr Surg 39:526–531

    Article  PubMed  Google Scholar 

  27. Stoll-Dannenhauer T, Schwab G, Zahn K et al (2021) Computed tomography based measurements to evaluate lung density and lung growth after congenital diaphragmatic hernia. Sci Rep 11:5035

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Waag KL, Loff S, Zahn K et al (2008) Congenital diaphragmatic hernia: a modern day approach. Semin Pediatr Surg 17:244–254

    Article  PubMed  Google Scholar 

  29. Wang X, Shi Q, Pan W et al (2022) Mediastinal shift angle in fetal MRI is associated with prognosis, severity, and cardiac underdevelopment in left congenital diaphragmatic hernia. Front Pediatr 10:907724

    Article  PubMed  PubMed Central  Google Scholar 

  30. Weis M, Burhany S, Perez Ortiz A et al (2021) The chest radiographic thoracic area can serve as a prediction marker for morbidity and mortality in infants with congenital diaphragmatic hernia. Front Pediatr 9:740941

    Article  PubMed  PubMed Central  Google Scholar 

  31. Weis M, Hoffmann S, Henzler C et al (2018) Isolated impact of liver herniation on outcome in fetuses with congenital diaphragmatic hernia—a matched-pair analysis based on fetal MRI relative lung volume. Eur J Radiol 105:148–152

    Article  CAS  PubMed  Google Scholar 

  32. Weis M, Zoellner FG, Hagelstein C et al (2016) Lung perfusion MRI after congenital diaphragmatic hernia repair in 2‑year-old children with and without extracorporeal membrane oxygenation therapy. AJR Am J Roentgenol 206:1315–1320

    Article  PubMed  Google Scholar 

  33. Wright JC, Budd JL, Field DJ et al (2011) Epidemiology and outcome of congenital diaphragmatic hernia: a 9-year experience. Paediatr Perinat Epidemiol 25:144–149

    Article  PubMed  Google Scholar 

  34. Zahn KB, Schaible T, Rafat N et al (2021) Longitudinal Follow-Up With Radiologic Screening for Recurrence and Secondary Hiatal Hernia in Neonates With Open Repair of Congenital Diaphragmatic Hernia—A Large Prospective, Observational Cohort Study at One Referral Center. Front Pediatr 9:796478

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to M. Weis M. Sc..

Ethics declarations

Interessenkonflikt

G. Thater, S. Appelhaus, S.O. Schoenberg und M. Weis geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autor/-innen keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

Additional information

Hinweis des Verlags

Der Verlag bleibt in Hinblick auf geografische Zuordnungen und Gebietsbezeichnungen in veröffentlichten Karten und Institutsadressen neutral.

figure qr

QR-Code scannen & Beitrag online lesen

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Thater, G., Appelhaus, S., Schoenberg, S.O. et al. Kongenitale Zwerchfellhernie. Radiologie (2024). https://doi.org/10.1007/s00117-024-01289-x

Download citation

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s00117-024-01289-x

Schlüsselwörter

Keywords

Navigation