ArticleEuropean radiology2026
Intraindividual development of MR lung perfusion parameters in children after congenital diaphragmatic hernia at 2 and 10 years.
Article in European radiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveThis study aimed to analyze the intraindividual development of lung perfusion in children with congenital diaphragmatic hernia (CDH) at the ages of 2 and 10 years, as well as to investigate prenatal and postnatal influencing factors. MATERIALS AND
methodsFifty-nine children after CDH were examined as part of a monocentric follow-up program using dynamic contrast-enhanced MRI (DCE-MRI) at 2 years (hereafter referred to as Examination 1, E1) and again at 10 years of age (Examination 2, E2). Pulmonary blood flow (PBF) and pulmonary blood volume (PBV) were quantified separately for each lung. Additionally, prenatal parameters (observed-to-expected fetal lung volume, o/e FLV) and postnatal factors (extracorporeal membrane oxygenation (ECMO); fetoscopic tracheal occlusion (FETO); patch repair; recurrence; and reoperation for recurrence) were recorded.
resultsIpsilateral perfusion remained consistently reduced between E1 and E2 (63.4 ± 27.8 vs 62.0 ± 23.6 mL/100 mL/min; p = 0.8001), while PBV significantly decreased (p = 0.0213). Low prenatal o/e FLV values correlated with reduced ipsilateral PBF (E1: r = 0.51; p = 0.0082; E2: r = 0.03; p = 0.0342). Patients who underwent ECMO showed a decrease in contralateral PBF over time (p = 0.0435), and those with FETO tended to exhibit poorer perfusion courses.
conclusionPatients with prenatally more severe lung hypoplasia, particularly those with low o/e FLV, exhibit persistently reduced lung perfusion even in the long term. These ongoing impairments remain stable over time, indicating permanently compromised lung development. Early identification and detailed risk assessment are therefore essential to initiate targeted therapeutic interventions. KEY POINTS: Question Lung perfusion development in children with CDH between ages 2 and 10, including prenatal and postnatal influencing factors. Findings Ipsilateral lung perfusion remained reduced, PBV decreased, and low prenatal o/e FLV correlated with persistently impaired perfusion. Clinical relevance Children with severe prenatal lung hypoplasia show lasting perfusion deficits into adolescence. Early risk assessment enables timely, targeted interventions to mitigate long-term pulmonary impairment.
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