Kuwashima Shigeko
Department of Radiology, Dokkyo University School of Medicine.
Nihon Igaku Hoshasen Gakkai Zasshi. 2005 Apr;65(2):105-8.
Congenital diaphragmatic hernia (CDH) is a developmental defect of the diaphragm with herniation of abdominal viscera into the thorax. The morbidity and mortality in cases is caused primarily by pulmonary hypoplasia. A prenatal diagnosis of CDH can be established by ultrasound, but ultrasound cannot detect pulmonary hypoplasia with certainty. We evaluated pulmonary hypoplasia by the simple method of lung intensity. The subjects were eight fetuses. In four fetuses, the lungs showed low intensity, and these fetuses all had pulmonary hypoplasia. Two of the four fetuses with high intensity showed a good prognosis, however, the other two fetuses did not. One of the two cases with poor prognosis had complex congenital heart disease, and the other died of sepsis and pulmonary hypertension. A high signal did not always promise a favorable prognosis, probably because accompanying abnormalities dominated the prognosis. MR assessment of lung intensity in fetuses with CDH may be useful in evaluating the severity of pulmonary hypoplasia. Low signal of the lung may reflect pulmonary hypoplasia and suggests a poor prognosis.
先天性膈疝（CDH）是一种膈肌发育缺陷，伴有腹腔脏器疝入胸腔。该病的发病率和死亡率主要由肺发育不全引起。CDH的产前诊断可通过超声确定，但超声无法确切检测到肺发育不全。我们通过肺强度的简单方法评估肺发育不全。研究对象为8例胎儿。4例胎儿的肺显示低强度，这些胎儿均有肺发育不全。4例高强度胎儿中有2例预后良好，然而，另外2例胎儿预后不佳。预后不良的2例病例中，1例患有复杂先天性心脏病，另1例死于败血症和肺动脉高压。高信号并不总是预示着良好的预后，可能是因为伴随的异常情况主导了预后。对患有CDH的胎儿进行肺强度的磁共振评估可能有助于评估肺发育不全的严重程度。肺的低信号可能反映肺发育不全，并提示预后不良。
