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12-05-2022 | Magnetic Resonance Imaging | Original Article

Quantitative cardiopulmonary magnetic resonance imaging in neonatal congenital diaphragmatic hernia

Authors: Jean A. Tkach, Nara S. Higano, Michael D. Taylor, Ryan A. Moore, Monir Hossain, Guixia Huang, David R. Spielberg, Sean B. Fain, Paul S. Kingma, Jason C. Woods

Published in: Pediatric Radiology | Issue 12/2022

Abstract

Background

Pulmonary arterial hypertension, impaired cardiac function and lung hypoplasia are common in infants with congenital diaphragmatic hernia (CDH) and are associated with increased morbidity and mortality. Robust noninvasive methods to quantify these abnormalities in early infancy are lacking.

Objective

To determine the feasibility of MRI to quantify cardiopulmonary hemodynamics and function in infants with CDH and to investigate left–right blood flow and lung volume discrepancies.

Materials and methods

We conducted a prospective MRI study of 23 neonates (isolated left CDH: 4 pre-repair, 7 post-repair, 3 pre- and post-repair; and 9 controls) performed on a small-footprint 1.5-tesla (T) scanner. We calculated MRI-based pulmonary arterial blood flow, left ventricular eccentricity index, cardiac function and lung volume. Using the Wilcoxon rank sum test for continuous data and Fisher exact test for categorical data, we made pairwise group comparisons.

Results

The right-to-left ratios for pulmonary artery blood flow and lung volume were elevated in pre-repair and post-repair CDH versus controls (flow: P<0.005; volume: P<0.05 pre−/post-repair). Eccentricity index at end-systole significantly differed between pre-repair and post-repair CDH (P<0.01) and between pre-repair CDH and controls (P<0.001).

Conclusion

Cardiopulmonary MRI is a viable method to serially evaluate cardiopulmonary hemodynamics and function in critically ill infants and is useful for capturing left–right asymmetries in pulmonary blood flow and lung volume.

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Title: Quantitative cardiopulmonary magnetic resonance imaging in neonatal congenital diaphragmatic hernia
Authors: Jean A. Tkach
Nara S. Higano
Michael D. Taylor
Ryan A. Moore
Monir Hossain
Guixia Huang
David R. Spielberg
Sean B. Fain
Paul S. Kingma
Jason C. Woods
Publication date: 12-05-2022
Publisher: Springer Berlin Heidelberg
Keywords: Magnetic Resonance Imaging
Magnetic Resonance Imaging
Diaphragmatic Hernia
Diaphragmatic Hernia
Arterial Hypertension
Arterial Hypertension
Published in: Pediatric Radiology / Issue 12/2022
Print ISSN: 0301-0449
Electronic ISSN: 1432-1998
DOI: https://doi.org/10.1007/s00247-022-05384-w

At a glance: The STEP trials

Springer Medicine

Quantitative cardiopulmonary magnetic resonance imaging in neonatal congenital diaphragmatic hernia

Abstract

Background

Objective

Materials and methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Objective

Materials and methods

Results

Conclusion

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