Quantitative cardiopulmonary magnetic resonance imaging in neonatal congenital diaphragmatic hernia

Jean A. Tkach*, Nara S. Higano, Michael D. Taylor, Ryan A. Moore, Monir Hossain, Guixia Huang, David R. Spielberg, Sean B. Fain, Paul S. Kingma, Jason C. Woods

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Pulmonary arterial hypertension, impaired cardiac function and lung hypoplasia are common in infants with congenital diaphragmatic hernia (CDH) and are associated with increased morbidity and mortality. Robust noninvasive methods to quantify these abnormalities in early infancy are lacking. Objective: To determine the feasibility of MRI to quantify cardiopulmonary hemodynamics and function in infants with CDH and to investigate left–right blood flow and lung volume discrepancies. Materials and methods: We conducted a prospective MRI study of 23 neonates (isolated left CDH: 4 pre-repair, 7 post-repair, 3 pre- and post-repair; and 9 controls) performed on a small-footprint 1.5-tesla (T) scanner. We calculated MRI-based pulmonary arterial blood flow, left ventricular eccentricity index, cardiac function and lung volume. Using the Wilcoxon rank sum test for continuous data and Fisher exact test for categorical data, we made pairwise group comparisons. Results: The right-to-left ratios for pulmonary artery blood flow and lung volume were elevated in pre-repair and post-repair CDH versus controls (flow: P<0.005; volume: P<0.05 pre−/post-repair). Eccentricity index at end-systole significantly differed between pre-repair and post-repair CDH (P<0.01) and between pre-repair CDH and controls (P<0.001). Conclusion: Cardiopulmonary MRI is a viable method to serially evaluate cardiopulmonary hemodynamics and function in critically ill infants and is useful for capturing left–right asymmetries in pulmonary blood flow and lung volume.

Original languageEnglish (US)
Pages (from-to)2306-2318
Number of pages13
JournalPediatric radiology
Volume52
Issue number12
DOIs
StatePublished - Nov 2022
Externally publishedYes

Keywords

  • Cardiac function
  • Congenital diaphragmatic hernia
  • Heart
  • Infants
  • Lungs
  • Magnetic resonance imaging
  • Neonatal intensive care unit
  • Pulmonary blood flow
  • Pulmonary hypertension

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Radiology Nuclear Medicine and imaging

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