Newborn Chest



This chapter reviews the common spectrum of disorders of the neonatal chest. Emphasis is on radiographic changes that have been produced by the introduction of new therapeutic maneuvers, particularly the use of artificial surfactant in treating hyaline membrane disease (HMD) and the survival of profoundly premature newborns (less than 650 g). A discussion of meconium aspiration syndrome (MAS), neonatal pneumonia, transient tachypnea of the newborn, congenital lymphangiectasia, and congenital heart disease is also included. The effect on the neonatal chest radiograph of extracorporeal membrane oxygenation and high-frequency ventilation are also mentioned. Some have paid particular attention to lung volume as a differentiating criterion of these lesions. Generally, HMD and neonatal pneumonia have been associated with low lung volumes, while congenital lymphangiectasia, MAS and transient tachypnea have been associated with normal or increased lung volume. However, many initial images are obtained only after the baby has been intubated and the lungs artificially inflated. There is also a considerable occurrence of concomitant diseases, i.e., HMD with pneumonia or transient tachypnea. Hence, there is no discussion of differentiating diseases based on lung volume.


Continuous Positive Airway Pressure Superior Vena Cava Hypoplastic Left Heart Syndrome Peripherally Insert Central Catheter Total Anomalous Pulmonary Venous Connection 
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. 1.
    Cleveland RH. A radiologic update on medical diseases of the newborn chest. Pediatr Radiol. 1995;25:631–7.PubMedCrossRefGoogle Scholar
  2. 2.
    Cleveland R, Donoghue V. Imaging of the newborn chest. Syllabus IDKD: diseases of the heart, chest & breast. Milan: Springer-Verlag Italia; 2007. p. 55–62.CrossRefGoogle Scholar
  3. 3.
    Welty S, Hansen TN, Corbet A. Respiratory distress in the preterm infant. In: Taeusch HW, Ballard RA, Gleason CA, editors. Avery’s diseases of the newborn. Philadelphia: Elsevier Saunders; 2005. p. 687–703.CrossRefGoogle Scholar
  4. 4.
    Zecca E, Costa S, Lauriola V, et al. Bile acid pneumonia: a “new” form of neonatal respiratory distress syndrome? Pediatrics. 2004;114:269–72.PubMedCrossRefGoogle Scholar
  5. 5.
    Clyman RI. Patent ductus arteriosus in the premature infant. In: Taeusch HW, Ballard RA, Gleason CA, editors. Avery’s diseases of the newborn. Philadelphia: Elsevier Saunders; 2005. p. 816–26.CrossRefGoogle Scholar
  6. 6.
    Northway WH, Rosan RC, Porter DY. Pulmonary disease following respirator therapy of hyaline-membrane disease: bronchopulmonary dysplasia. N Engl J Med. 1967;276:357–68.PubMedCrossRefGoogle Scholar
  7. 7.
    Jobe AH. The new BPD: an arrest of lung development. Pediatr Res. 1999;66:641–3.CrossRefGoogle Scholar
  8. 8.
    Hodgman JE. Relationship between Wilson-Mikity syndrome and the new BPD. Pediatrics. 2003;112:1414–5.PubMedCrossRefGoogle Scholar
  9. 9.
    Couser RJ, Ferrara TB, Ebert J, Hoekstra RE, Fangman JJ. Effects of exogenous surfactant therapy on dynamic compliance during mechanical breathing in preterm infants with hyaline membrane disease. J Pediatr. 1990;116:119–24.PubMedCrossRefGoogle Scholar
  10. 10.
    Leichty EA, Donovan E, Purohit D, et al. Reduction of neonatal mortality after multiple doses of bovine surfactant in low birth weight neonates with respiratory distress syndrome. Pediatrics. 1991;88:19–28.Google Scholar
  11. 11.
    American Academy of Pediatrics committee on Fetus and Newborn: Surfactant replacement therapy for respiratory distress syndrome. Pediatrics 1991;87:946–7.Google Scholar
  12. 12.
    Jackson JC, Troug WE, Standaert TA, et al. Effect of high-frequency ventilation on the development of alveolar edema in premature monkeys at risk for hyaline membrane disease. Am Rev Respir Dis. 1991;143:865–71.PubMedGoogle Scholar
  13. 13.
    Donnelly LF, Lucaya J, Ozelame V, et al. CT findings and temporal course of persistent pulmonary interstitial emphysema in neonates: a multiinstitutional study. AJR Am J Roentgenol. 2003;180:1129–33.PubMedGoogle Scholar
  14. 14.
    Swischuk LE. Bubbles in hyaline membrane disease. Differentiation of three types. Radiology. 1977;122:417–26.PubMedGoogle Scholar
  15. 15.
    Howling SJ, Northway WH, Hansell DM, et al. Pulmonary sequelae of bronchopulmonary dysplasia survivors: high-resolution CT findings. AJR Am J Roentgenol. 2000;174:1323–6.PubMedGoogle Scholar
  16. 16.
    Brudno DS, Boedy RF, Kanto WP. Compliance, ­alveolar-arterial oxygen difference, and oxygenation index changes in patients managed with extracorporeal membrane oxygenation. Pediatr Pulmonol. 1990;9:19–23.PubMedCrossRefGoogle Scholar
  17. 17.
    Gregory GA, Gooding CA, Phibbs RH, Tooley WH. Meconium aspiration in infants – a prospective study. J Pediatr. 1974;85:848–52.PubMedCrossRefGoogle Scholar
  18. 18.
    Lancet (editorial). Lung function in children after neonatal meconium aspiration. Lancet. 1988;2:317–8.Google Scholar
  19. 19.
    Cleveland R. Total anomalous pulmonary venous connection: Case 10. In: Siegel MJ, Bisset GS, Cleveland RH, Donaldson JS, Fellows KE, Patriquin HB, editors. ACR pediatric disease (fourth series) test and syllabus. Reston: American College of Radiology; 1993. p. 272–302.Google Scholar
  20. 20.
    Leonidas JC, Hall RT, Beatty EC, et al. Radiographic findings in early onset neonatal group B Streptococcal septicemia. Pediatrics. 1977;59(Suppl):1006–11.PubMedGoogle Scholar
  21. 21.
    Ursi D, Ursi J-P, Ieven M, et al. Congenital pneumonia due to Mycoplasma pneumoniae. Arch Dis Child. 1995;72:F118–20.CrossRefGoogle Scholar
  22. 22.
    Theilen U, Lyon AJ, Fitzgerald T, et al. Infection with Ureaplasma urealyticum: is there a specific clinical and radiological course in the preterm infant? Arch Dis Child Fetal Neonatal Ed. 2004;89:F163–7.PubMedCrossRefGoogle Scholar
  23. 23.
    McCarten KM, Rosenberg HK, Borden S, Mandell GA. Delayed appearance of right diaphragmatic hernia ­associated with group B streptococcal infection in ­newborns. Radiology. 1981;139:385–9.PubMedGoogle Scholar
  24. 24.
    Moskowitz PS, Griscom NT. The medial pneumothorax. Radiology. 1976;120:143–7.PubMedGoogle Scholar
  25. 25.
    Cleveland RH, Weber B. Retained fetal lung liquid in congenital lobar emphysema: a possible predictor of polyalveolar lobe. Pediatr Radiol. 1993;23:291–5.PubMedCrossRefGoogle Scholar
  26. 26.
    Hagmann C, Berger TM. Congenital pulmonary lymphangiectasia. N Engl J Med. 2003;349:e21.PubMedCrossRefGoogle Scholar
  27. 27.
    Chung CJ, Fordham LA, Barker P, et al. Children with congenital pulmonary Lymphangiectasia: after infancy. AJR Am J Roentgenol. 1999;173:1583–8.PubMedGoogle Scholar
  28. 28.
    Freed MD. Congenital cardiac malformations. In: Avery ME, Taeusch HW, editors. Schaffer’s diseases of the newborn. 5th ed. Philadelphia: WB Saunders; 1984. p. 243–90.Google Scholar
  29. 29.
    Schachter J. Chlamydial infections (first of three parts). New Engl J Med. 1978;298:428–35.PubMedCrossRefGoogle Scholar
  30. 30.
    Schachter J. Chlamydial infections (second of three parts). New Engl J Med. 1978;298:490–5.PubMedCrossRefGoogle Scholar
  31. 31.
    Schachter J. Chlamydial infections (third of three parts). New Engl J Med. 1978;298:540–9.PubMedCrossRefGoogle Scholar
  32. 32.
    Todres ID, deBros F, Kramer SS. Endotracheal tube displacement in the newborn infant. J Pediatr. 1976;89:126–7.PubMedCrossRefGoogle Scholar
  33. 33.
    Baskin KM, Jimenez RM, Cahill AM, et al. Cavoatrial junction and central venous anatomy: implications for central venous access tip position. J Vasc Interv Radiol. 2008;19:359–65.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of RadiologyHarvard Medical SchoolBostonUSA
  2. 2.Departments of Radiology and Medicine, Division of Respiratory DiseasesChildren’s Hospital BostonBostonUSA
  3. 3.Center for Healthy Infant Lung Development, Divisions of Newborn Medicine and Respiratory DiseasesChildren’s Hospital BostonBostonUSA

Personalised recommendations