Fetal MR Imaging of the Chest

  • Pedro Daltro
  • Heron Werner
  • Taísa Davaus Gasparetto
Part of the Medical Radiology book series (MEDRAD)


Magnetic resonance (MR) imaging is nowadays widely used in more complex cases of fetal malformation as an important complement to prenatal ultrasound. Due to the higher contrast resolution than ultrasound, the fetal MR imaging allows better differentiation of normal from abnormal tissue, providing detailed imaging information of the fetal structures, particularly the lungs. Congenital chest malformations may affect the foregut, pulmonary airway, and vasculature. Hybrid conditions are commonly seen with interrelated chest malformations having various radiologic and pathologic features. To date, fetal MR imaging has shown to have an important role in the evaluation of lung abnormalities sonographically suspected, leading to a more specific diagnosis and helping to access the development of the remaining lung parenchyma.


Congenital Diaphragmatic Hernia Hypoplastic Left Heart Syndrome Congenital Diaphragmatic Hernia Pulmonary Hypoplasia Bronchogenic Cyst 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. Adzick NS, Harrison MR, Glick PL (1985) Fetal cystic adenomatoid malformation: prenatal diagnosis and natural history. J Pediatr Surg 20:483–488PubMedCrossRefGoogle Scholar
  2. Albanese CT, Lopoo J, Goldstein RB (1998) Fetal liver position and perinatal outcome for congenital diaphragmatic hernia. Prenat Diagn 18:1138–1142PubMedCrossRefGoogle Scholar
  3. Bedoyan JK, Blackwell SC, Treadwell MC, Johnson A, Klein MD (2004) Congenital diaphragmatic hernia: associated anomalies and antenatal diagnosis. Pediatr Surg Int 20:170–176PubMedCrossRefGoogle Scholar
  4. Biyyam DR, Chapman T, Ferguson MR, Deutsch G, Dighe MK (2010) Congenital lung abnormalities: embryologic features, prenatal diagnosis, and postnatal radiologic-pathologic correlation. Radiographics 30:721–738CrossRefGoogle Scholar
  5. Bulas D, Egloff AM (2011) Fetal chest ultrasound and magnetic resonance imaging: recent advances and current clinical applications. Radiol Clin North Am 49:805-823. This bibliography is not mentioned on the textGoogle Scholar
  6. Coakley FV, Glenn OA, Qayyum A, Barkovich AJ, Goldstein R, Filly RA (2004) Fetal MRI: a developing technique for the developing patient. AJR Am J Roentgenol 182:243–252PubMedCrossRefGoogle Scholar
  7. Daltro P, Fricke BL, Kuroki I, Domingues R, Donnelly LF (2004) CT of congenital lung lesions in pediatric patients. AJR 183:1479–1506CrossRefGoogle Scholar
  8. Daltro P, Werner H, Gasparetto TD, Domingues RC, Rodrigues L, Marchiori E, Gasparetto E (2010) Congenital chest mal-formations: a multimo-dality approach with emphasis on fetal MR imaging. RadioGraphics 30:385–395PubMedCrossRefGoogle Scholar
  9. Deprest J, Jani J, Van Schoubroeck et al (2006a) Current consequences of prenatal diagnosis of congenital diaphragmatic hernia. J Pediatr Surg 41:423–430Google Scholar
  10. Deprest J, Jani J, Van Schoubroeck et al (2006b) Prenatal intervention for isolated congenital diaphragmatic hernia. Curr Opin Obstet Gynecol 18:203–215Google Scholar
  11. Dubois J, Patriquin HB, Garel L, Powell J, Filiatrault D, David M, Grignon A (1998) Soft-tissue hemangiomas in infants and children: diagnosis using Doppler sonography. AJR Am J Roentgenol 171(1):247–252PubMedCrossRefGoogle Scholar
  12. Epelman M, Kreiger PA, Servaes S, Victoria T, Hellinger JC (2010) Current imaging of prenatally diagnosed congenital lung lesions. Semin Ultrasound CT MR 31:141–157PubMedCrossRefGoogle Scholar
  13. Faul JL, Berry GJ, Colby TV et al (2000) Thoracic lymphangioma, lymphagiectasis, lymphangiomatosis, and lymphatic dysplasia syndrome. Am J Respir Crit Care Med 161:1037–1046PubMedGoogle Scholar
  14. Guo Y, Luo B (2006) The state of the art of fetal magnetic resonance imaging. Chin Med J 119(15):1294–1299PubMedGoogle Scholar
  15. Hansell DM, Armstrong P, Lynch DA, McAdams HP (2005) Congenital anomalies. In: Imaging of the diseases of the chest, 4th edn. Elsevier, MosbyGoogle Scholar
  16. Harrison MR, Adzick NS, Estes JM, Howell LJ (1994) A prospective study of the outcome for fetuses with diaphragmatic hernia. JAMA 271:382–384PubMedCrossRefGoogle Scholar
  17. Harrison MR, Keller RL, Hawgood SB et al (2003) A randomized trial of fetal endoscopic tracheal occlusion for severe fetal congenital diaphragmatic hernia. N Engl J Med 349(20):1916–1924PubMedCrossRefGoogle Scholar
  18. Hata K, Hata T, Manabe A (1995) Hypoplastic left heart syndrome: color Doppler sonographic and magnetic resonance imaging features in utero. Gynecol Obstet Invest 39:70–72PubMedCrossRefGoogle Scholar
  19. Hedrick HL, Crombleholme TM, Flake AW et al (2004) Right congenital diaphragmatic hernia: prenatal assessment and outcome. J Pediatr Surg 39(3):319–323PubMedCrossRefGoogle Scholar
  20. Hiasa KI, Fujita Y, Fukushima K, Nagata K, Taguchi T, Wake N (2012) Ultrasound and MR images of prenatally diagnosed bilateral congenital diaphragmatic hernia, a rare variation of CDH. Clin Imaging 36(5):639–642PubMedCrossRefGoogle Scholar
  21. Hubbard AM, Adzick NS, Crombleholme TM et al (1999) Congenital chest lesions: diagnosis and characterization with prenatal MR Imaging. Radiology 212:48–49CrossRefGoogle Scholar
  22. Jani J, Peralta CF, Van Schoubroeck D et al (2006) Relationship between lung-to-head ratio and lung volume in normal fetuses and fetuses with diaphragmatic hernia. Ultrasound Obstet Gynecol 27:545–550PubMedCrossRefGoogle Scholar
  23. Jani JC, Cannie M, Peralta CFA, Deprest JA, Nico-laides KH, Dymarkowski S (2007) Lung volumes in fetuses with congenital diaphragmatic hernia: comparison of 3D US and MR imaging assessments. Radiology 244:575–582PubMedCrossRefGoogle Scholar
  24. Jani JC, Peralta CF, Nicolaides KH (2012) Lung-to-head ratio: a need to unify the technique. Ultrasound Obstet Gynecol 39:2–6PubMedCrossRefGoogle Scholar
  25. Jasnosz KM, Hermansen MC, Snider C et al (1994) Congenital complete absence (bilateral agenesis) of the diaphragm: a rare variant of congenital diaphragmatic hernia. Am J Perinatol 11:340–343PubMedCrossRefGoogle Scholar
  26. Kasprian G, Balassy C, Brugger P, Prayer D (2006) MRI of normal and pathological fetal lung development. Eur Radiol 57:261–270Google Scholar
  27. Kassanos D, Christodoulou CV, Agapitos E et al (1997) Prenatal ultrasonographic detection of the tracheal atresia sequence. Ultrasound Obstetric Gynecol 10:133–136CrossRefGoogle Scholar
  28. Kays DW (2006) Congenital diaphragmatic hernia and neonatal lung lesions. Sur Clin N Am 86:329–352Google Scholar
  29. Kul S, Korkmaz HA, Cansu A et al (2012) Contribution of MRI to ultrasound in the diagnosis of fetal anomalies. J Magn Reson Imaging 35:882–890PubMedGoogle Scholar
  30. Kuwashima S, Nishimura G, Iimura F et al (2001) Low-intensity fetal lungs on MRI may suggest the diagnosis of pulmonary hypoplasia. Pediatr Radiol 31:669–672PubMedCrossRefGoogle Scholar
  31. Leung JWT, Coackley FV, Hricak H et al (2000) Prenatal MR imaging of congenital diaphragmatic hérnia. Am Roentgen 174:1607–1612CrossRefGoogle Scholar
  32. Levine D, Banewolt CE, Mehta TS et al (2003) Fetal thoracic abnormalities: MR imaging. Radiology 228:379–388PubMedCrossRefGoogle Scholar
  33. Mahieu-Caputo D, Sonigo P, Dommergues M et al (2001) Fetal lung volume measurement by magnetic resonance imaging in congenital diaphragmatic hernia. BJOG 108:863–868PubMedGoogle Scholar
  34. Matsuoka S, Takeuchi K, Yamanaka Y et al (2003) Comparison of magnetic resonance imaging and ultrasonography in the prenatal diagnosis of congenital thoracic abnormalities. Fetal Diagn Ther 18:447–453PubMedCrossRefGoogle Scholar
  35. Mehollin-Ray AR, Cassady CI, Cass DL, Olutoye OO (2012) Fetal MR imaging of congenital diaphragmatic hernia. Radiographics 32:1067–1084PubMedCrossRefGoogle Scholar
  36. Metkus AP, Filly RA, Stringer MD et al (1996) Sonographic predictors of survival in fetal diaphragmatic hernia. J Pediatr Surg 31:148–151PubMedCrossRefGoogle Scholar
  37. Newman B (2006) Congenital bronchopulmonary foregut malformations: concepts and controversies. Pediatr Radiol 36:773–791PubMedCrossRefGoogle Scholar
  38. Okazaki T, Kohno S, Hasegawa S et al (2003) Congenital diaphragmatic hernia: efficacy of ultrasound examination in its management. Pediatr Surg Int 19:176–179PubMedGoogle Scholar
  39. Paulson TE, Spear RM, Peterson BM (1995) New concepts in the treatment of children with acute respiratory distress syndrome. J Pediatr 127:163–175PubMedCrossRefGoogle Scholar
  40. Paek BW, Coakley FV, Yiung Lu et al (2001) Congenital diaphragmatic hernia: prenatal evaluation with MR lung volumetry—preliminary experience. Radiology 220:63–67Google Scholar
  41. Peralta CF, Cavoretto P, Csapo B et al (2005) Assessment of lung area in normal fetuses at 12–32 weeks. Ultrasound Obstet Gynecol 26:718–724PubMedCrossRefGoogle Scholar
  42. Recio Rodríguez M, Martínez de Vega V, Cano Alonso R, Carrascoso Arranz J, Martínez Ten P, Pérez Pedregosa J (2012) MR imaging of thoracic abnormalities in the fetus. Radiographics 32:E305–E321Google Scholar
  43. Ruano R, Joubin L, Sonigo P et al (2004) Fetal lung volume estimated by 3-dimensional ultrasonography and magnetic resonance imaging in cases with isolated congenital diaphragmatic hernia. J Ultrasound Med 23:353–358PubMedGoogle Scholar
  44. Saleem SN (2008) Feasibility of MRI of the fetal heart with balanced steady-state free precession sequence along fetal body and cardiac planes. AJR 191:1208–1215PubMedCrossRefGoogle Scholar
  45. Schrey S, Kelly EN, Langer JC et al (2012) Fetal thoracoamniotic shunting for large macrocystic congenital cystic adenomatoid malformations of the lung. Ultrasound Obstet Gynecol 39:515–520PubMedCrossRefGoogle Scholar
  46. Shellock FG, Kanal E (1991) Policies, guidelines, and recommendations for MR imaging safety and patient management. SMRI safety committee. J Magn Reason Imaging 1:97–101CrossRefGoogle Scholar
  47. Shinmoto H, Kashima K, Yuasa Y et al (2000) MR imaging of non-CNS fetal abnormalities: a pictorial essay. RadioGraphics 20(5):1227–1243PubMedCrossRefGoogle Scholar
  48. Stocker JT, Madewell JE, Drake RM (1977) Congenital cystic adenomatoid malformation: prenatal diagnosis and natural history. J Pediatr Surg 8:155–158Google Scholar
  49. Stoker JT (2002) Congenital pulmonary airway malformation: a new name for and an expanded classification of congenital cystic adenomatoid malformation of the lung. Symposium 24: non-neoplastic lung disease. Histopathology 41:424–30Google Scholar
  50. Stocker JT (2009) Cystic lung disease in infants and children. Fetal Pediatr Pathol 28:155–184PubMedCrossRefGoogle Scholar
  51. Wang SM, Lin CH, Lin YJ et al (1997) Congenital bilateral agenesis of diaphragm: report of a case. Eur J Pediatr 156:572–574PubMedCrossRefGoogle Scholar
  52. Werner H, Dos Santos JRL, Fontes R, Daltro P, Gasparetto E, Marchiori E, Campbell S (2010) Additive manufacturing models of fetuses built from three-dimensional ultrasound, magnetic resonance imaging and computed tomography scan data. Ultrasound Obstet Gynecol 36:355–361PubMedCrossRefGoogle Scholar
  53. Werner H, Dos Santos JRL, Fontes R, Daltro P, Gasparetto E, Marchiori E, Campbell S (2011) Virtual bronchoscopy in the fetus. Ultrasound Obstet Gynecol 37:113–115PubMedCrossRefGoogle Scholar
  54. Werner H, Mirlesse V, Jacquemard F et al (1994) Prenatal diagnosis of tuberous sclerosis. Use of magnetic resonance imaging and its implications for prognosis. Prenat Diagn 14:1151–1154PubMedCrossRefGoogle Scholar
  55. Witlox RS, Lopriore E, Oepkes D (2011) Prenatal interventions for fetal lung lesions. Prenat Diagn 31:628–636PubMedCrossRefGoogle Scholar
  56. Woodward PF, Sohaey R, Kennedy A et al (2005) A comprehensive review of fetal tumors with pathologic correlation. RadioGraphics 25:215–242PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Pedro Daltro
    • 1
    • 2
  • Heron Werner
    • 1
  • Taísa Davaus Gasparetto
    • 1
  1. 1.Clínica de Diagnóstico por Imagem-CDPIRio de JaneiroBrazil
  2. 2.Hospital dos Servidores do Estado-H.S.E.Rio de JaneiroBrazil

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