Radiographic findings of diaphragmatic hernia and hypoplastic lung

• Published in: Journal of perinatology Vol. 30; no. 2; pp. 140 - 143
• Main Authors: Shimono, R, Ibara, S, Maruyama, Y, Maruyama, H, Tokuhisa, T, Noguchi, H, Takamatsu, H
• Format: Journal Article
• Language: English
• Published: New York Nature Publishing Group US 01.02.2010; Nature Publishing Group
• Subjects: Apexes; Birth weight; Chest; Diaphragm; Extracorporeal membrane oxygenation; Female; Gestational age; Health aspects; Hernia; Hernia, Diaphragmatic - classification; Hernia, Diaphragmatic - diagnostic imaging; Hernias; Hernias, Diaphragmatic, Congenital; Hospitals; Humans; Hypoplasia; Infant, Newborn; Lung - abnormalities; Lung - diagnostic imaging; Lung Volume Measurements; Lungs; Male; Medical prognosis; Medicine; Medicine & Public Health; Neonates; original-article; Oxygenation; Pediatric Surgery; Pediatrics; Pregnant women; Prenatal diagnosis; Prognosis; Radiography; Radiography, Medical; Surgery; Survival; Survival Analysis; Thorax; Tomography; X-rays; Japan; United States > US; congenital diaphragmatic hernia; hypoplastic lung; chest X-ray; lung volume
• ISSN: 0743-8346; 1476-5543
• DOI: 10.1038/jp.2009.129

Objective: Congenital diaphragmatic hernia (CDH) has a poor prognosis, despite intensive management. The prognosis of CDH is correlated with hypoplastic lung, but it is difficult to measure the degree of hypoplasia. The aims of this study were, therefore, to examine the relationship between chest X-ray and prognosis, and to assess whether the radiographic findings were a good indicator of hypoplastic lungs in patients with CDH. Study Design: Fifty neonates with CDH were classified radiographically into apex and hilar types. To assess the differences in clinical course between these two groups, gestational age, birth weight, prenatal diagnosis, survival rate, requirement of extracorporeal membrane oxygenation (ECMO) therapy and lung area on X-rays were analyzed. Results: In all, 32 cases were of the apex type and 18 were hilar. The survival rate of the hilar group (33%) was significantly worse than that of the apex group (81%) ( P <0.001). The hilar group required ECMO therapy more frequently than did the apex group. Conclusions: The present results show a significant correlation between survival rate and the findings of chest X-rays in CDH. Radiographic findings are thus a good clinical indicator of the prognosis of CDH in neonates.