Prenatal lung volumes and postnatal lung perfusion in congenital diaphragmatic hernia: A pilot study

Abstract

Background: Congenital diaphragmatic hernia (CDH) significantly impacts long-term pulmonary function. This study aimed to compare fetal MRI-derived lung volumes with nuclear medicine perfusion scintigraphy (NMPS) data to identify correlations and improve prognostication and management for children with CDH.

Study design: This retrospective single-center pilot cohort study included infants born between 2019 and 2022 with prenatally diagnosed left-sided CDH who underwent both fetal MRI and postnatal NMPS. Lung volumes were converted to a percentage of total lung volume for comparison with lung perfusion percentages. Relationships between fetal MRI and NMPS ratios were assessed using paired t-tests and Pearson correlation.

Results: Thirteen children met the inclusion criteria. The prenatal and postnatal ratios of left, right, and left/right lung were significantly different between fetal MRI and NMPS (p < 0.001). A not statistically significant trend toward positive correlation was observed.

Conclusion: There was no significant correlation between fetal MRI lung volume and postnatal NMPS lung perfusion, which supports obtaining perfusion studies as a part of risk-stratified follow-up. Larger multicenter studies are needed to confirm these preliminary findings.

Type of study: Retrospective observational single-center cohort study.

Level of evidence: III.

Keywords: Congenital diaphragmatic hernia; Long-term follow-up; Lung perfusion; Lung volume; Nuclear medicine perfusion scintigraphy.