Assessment of lung development in isolated congenital diaphragmatic hernia using signal intensity ratios on fetal MR imaging

Csilla Balassy, Gregor Kasprian, Peter C. Brugger, Michael Weber, Bence Csapo, Christian Herold, Daniela Prayer

Research output: Contribution to journalArticlepeer-review

29 Scopus citations


Objectives: To investigate developmental changes in the apparently unaffected contralateral lung by using signal intensity ratios (SIR) and lung volumes (LV), and to search for correlation with clinical outcome. Methods: Twenty-five fetuses (22-37 weeks' gestation) were examined. Lung/liver signal intensity ratios (LLSIR) were assessed on T1-weighted and T2-weighted sequences for both lungs, then together with LV compared with age-matched controls of 91 fetuses by using the U test. Differences in LLSIRs and lung volumes were correlated with neonatal outcomes. Results: LLSIRs in fetuses with congenital diaphragmatic hernia (CDH) were significantly higher in both lungs on T1-weighted images and significantly lower on T2-weighted images, compared with normals (p < 0.05), increasing on T2-weighted imaging and decreasing on T1-weighted imaging during gestation. Total LV were significantly smaller in the CDH group than in controls (p < 0.05). No significant differences in LLSIR of the two lungs were found. Outcomes correlated significantly with total LV, but not with LLSIR. Conclusion: Changes in LLSIR seem to reflect developmental impairment in CDH; however, they provide no additional information in predicting outcome. LV remains the best indicator on fetal MR imaging of neonatal survival in isolated, left-sided CDH.

Original languageEnglish (US)
Pages (from-to)829-837
Number of pages9
JournalEuropean radiology
Issue number4
StatePublished - 2010


  • Congenital diaphragmatic hernia
  • Fetal MR imaging
  • Fetal lung
  • Signal intensities
  • Structural changes

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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