• D Mahieu-Caputo, P Sonigo, M Dommergues, J C Fournet, J C Thalabard, C Abarca, A Benachi, F Brunelle, and Y Dumez.
• Necker Hospital for Sick Children, Paris, France.
• BJOG. 2001 Aug 1; 108 (8): 863-8.

ObjectiveTo study the potential for prenatal magnetic resonance imaging to predict pulmonary hypoplasia in congenital diaphragmatic hernia.DesignProspective observational study.SettingTertiary care centre.ParticipantsThirteen cases of congenital diaphragmatic hernia (11 left, 2 right) without associated anomalies and 74 controls.MethodsMeasurements by magnetic resonance imaging of fetal lung volume were achieved. In the control fetuses, a regression analysis was performed to associate fetal lung volume with gestational age. This yielded a formula allowing calculation of the expected fetal lung volume as a function of gestational age. In the cases with congenital diaphragmatic hernia, the observed/expected fetal lung volume ratio was compared with perinatal outcome.Main Outcome MeasuresNeonatal mortality and pulmonary hypoplasia, which was defined as lung/body weight ratios less than 0.012.ResultsThe expected fetal lung volume was derived from the following formula: Fetal lung volume (mL) = exp (1.24722 + 0.08939 x gestational age in weeks). The observed/expected fetal lung volume ratio was significantly lower in congenital diaphragmatic hernia (median: 0.31, range: 0.06-0.63), than in controls (median: 0.99, range: 0.42-1.94). This ratio was significantly less in the infants with congenital diaphragmatic hernia who died (median: 0.26, range: 0.06-0.63) compared with those who survived (median: 0.46, range: 0.35-0.56). The observed: expected fetal lung volume ratio was significantly correlated with the post mortem lung: body weight ratio.ConclusionIn isolated congenital diaphragmatic hernia, fetal lung volume measurement by magnetic resonance imaging is a potential predictor of pulmonary hypoplasia and postnatal outcome. Further studies are required to establish the clinical value of magnetic resonance imaging for the prenatal assessment of fetal lungs.

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