Imaging Assessment of Prognostic Parameters in Cases of Isolated Congenital Diaphragmatic Hernia: Integrative Review

Avaliação de fatores prognósticos por métodos de imagem em casos de hérnia diafragmática congênita isolada: Revisão integrativa

Abstract

Objective

Antenatal recognition of severe cases of congenital diaphragmatic hernia (CDH) by ultrasound (US) and magnetic resonance imaging (MRI) may aid decisions regarding the indication of fetal endoscopic tracheal occlusion.

Methods

An integrative review was performed. Searches in MEDLINE and EMBASE used terms related to CDH, diagnosis, MRI, and US. The inclusion criteria were reviews and guidelines approaching US and MRI markers of severity of CDH published in English in the past 10 years.

Results

The search retrieved 712 studies, out of which 17 publications were included. The US parameters were stomach and liver positions, lung-to-head ratio (LHR), observed/expected LHR (o/e LHR), and quantitative lung index. The MRI parameters were total fetal lung volume (TFLV), observed/expected TFLV, relative fetal or percent predicted lung volumes, liver intrathoracic ratio, and modified McGoon index. None of the parameters was reported to be superior to the others.

Conclusion

The most mentioned parameters were o/e LHR, LHR, liver position, o/e TFLV, and TFLV.

Keywords:
hernias diaphragmatic congenital; ultrasonography prenatal; magnetic resonance imaging; patient selection; reference standards