Abdominal contents herniate into chest via diaphragmatic defect
Foramen of Bochdalek: Posterior defect
Most common type in fetuses
Foramen of Morgagni: Anterior defect
More often right sided
Uncommonly, herniation through esophageal hiatus or diaphragmatic agenesis
IMAGING
General Features
Ultrasonographic Findings
MR Findings
Imaging Recommendations
Calculations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Image Interpretation Pearls
Selected References
Perinatology: Lung-to-head ratio calculator. Accessed June 26, 2020. http://perinatology.com/calculators/LHR.htm
Abbasi N et al: Variability in antenatal prognostication of fetal diaphragmatic hernia across the North American fetal therapy network (NAFTNet). Prenat Diagn. 40(3):342-50, 2020
Dütemeyer V et al: Prenatal prediction of postnatal survival in fetuses with congenital diaphragmatic hernia using MRI: lung volume measurement, signal intensity ratio, and effect of experience. J Matern Fetal Neonatal Med. 1-9, 2020
Meyers ML et al: Fetal lung volumes by MRI: normal weekly values from 18 through 38 weeks' gestation. AJR Am J Roentgenol. 211(2):432-8, 2018
Oluyomi-Obi T et al: Antenatal predictors of outcome in prenatally diagnosed congenital diaphragmatic hernia (CDH). J Pediatr Surg. 52(5):881-8, 2017
Al-Maary J et al: Fetal tracheal occlusion for severe pulmonary hypoplasia in isolated congenital diaphragmatic hernia: a systematic review and meta-analysis of survival. Ann Surg. 264(6):929-33, 2016
Basta AM et al: Fetal stomach position predicts neonatal outcomes in isolated left-sided congenital diaphragmatic hernia. Fetal Diagn Ther. 39(4):248-55, 2016
Kastenholz KE et al: Correlation of observed-to-expected MRI fetal lung volume and ultrasound lung-to-head ratio at different gestational times in fetuses with congenital diaphragmatic hernia. AJR Am J Roentgenol. 206(4):856-66, 2016
Sananes N et al: Improving the prediction of neonatal outcomes in isolated left-sided congenital diaphragmatic hernia by direct and indirect sonographic assessment of liver herniation. J Ultrasound Med. 35(7):1437-43, 2016
Lusk LA et al: Fetal ultrasound markers of severity predict resolution of pulmonary hypertension in congenital diaphragmatic hernia. Am J Obstet Gynecol. 213(2):216.e1-8, 2015
Zamora IJ et al: Prenatal MRI fetal lung volumes and percent liver herniation predict pulmonary morbidity in congenital diaphragmatic hernia (CDH). J Pediatr Surg. 49(5):688-93, 2014
Debus A et al: Fetal lung volume in congenital diaphragmatic hernia: association of prenatal MR imaging findings with postnatal chronic lung disease. Radiology. 266(3):887-95, 2013
Jani JC et al: Lung-to-head ratio: a need to unify the technique. Ultrasound Obstet Gynecol. 39(1):2-6, 2012
Mehollin-Ray AR et al: Fetal MR imaging of congenital diaphragmatic hernia. Radiographics. 32(4):1067-84, 2012
Alfaraj MA et al: Congenital diaphragmatic hernia: lung-to-head ratio and lung volume for prediction of outcome. Am J Obstet Gynecol. 205(1):43.e1-8, 2011
Knox E et al: Prenatal detection of pulmonary hypoplasia in fetuses with congenital diaphragmatic hernia: a systematic review and meta-analysis of diagnostic studies. J Matern Fetal Neonatal Med. 23(7):579-88, 2010
Laudy JA et al: Congenital diaphragmatic hernia: an evaluation of the prognostic value of the lung-to-head ratio and other prenatal parameters. Prenat Diagn. 23(8):634-9, 2003
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Pathology
Clinical Issues
TERMINOLOGY
Abbreviations
Congenital diaphragmatic hernia (CDH)
Definitions
Abdominal contents herniate into chest via diaphragmatic defect
Foramen of Bochdalek: Posterior defect
Most common type in fetuses
Foramen of Morgagni: Anterior defect
More often right sided
Uncommonly, herniation through esophageal hiatus or diaphragmatic agenesis
IMAGING
General Features
Ultrasonographic Findings
MR Findings
Imaging Recommendations
Calculations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Image Interpretation Pearls
Selected References
Perinatology: Lung-to-head ratio calculator. Accessed June 26, 2020. http://perinatology.com/calculators/LHR.htm
Abbasi N et al: Variability in antenatal prognostication of fetal diaphragmatic hernia across the North American fetal therapy network (NAFTNet). Prenat Diagn. 40(3):342-50, 2020
Dütemeyer V et al: Prenatal prediction of postnatal survival in fetuses with congenital diaphragmatic hernia using MRI: lung volume measurement, signal intensity ratio, and effect of experience. J Matern Fetal Neonatal Med. 1-9, 2020
Meyers ML et al: Fetal lung volumes by MRI: normal weekly values from 18 through 38 weeks' gestation. AJR Am J Roentgenol. 211(2):432-8, 2018
Oluyomi-Obi T et al: Antenatal predictors of outcome in prenatally diagnosed congenital diaphragmatic hernia (CDH). J Pediatr Surg. 52(5):881-8, 2017
Al-Maary J et al: Fetal tracheal occlusion for severe pulmonary hypoplasia in isolated congenital diaphragmatic hernia: a systematic review and meta-analysis of survival. Ann Surg. 264(6):929-33, 2016
Basta AM et al: Fetal stomach position predicts neonatal outcomes in isolated left-sided congenital diaphragmatic hernia. Fetal Diagn Ther. 39(4):248-55, 2016
Kastenholz KE et al: Correlation of observed-to-expected MRI fetal lung volume and ultrasound lung-to-head ratio at different gestational times in fetuses with congenital diaphragmatic hernia. AJR Am J Roentgenol. 206(4):856-66, 2016
Sananes N et al: Improving the prediction of neonatal outcomes in isolated left-sided congenital diaphragmatic hernia by direct and indirect sonographic assessment of liver herniation. J Ultrasound Med. 35(7):1437-43, 2016
Lusk LA et al: Fetal ultrasound markers of severity predict resolution of pulmonary hypertension in congenital diaphragmatic hernia. Am J Obstet Gynecol. 213(2):216.e1-8, 2015
Zamora IJ et al: Prenatal MRI fetal lung volumes and percent liver herniation predict pulmonary morbidity in congenital diaphragmatic hernia (CDH). J Pediatr Surg. 49(5):688-93, 2014
Debus A et al: Fetal lung volume in congenital diaphragmatic hernia: association of prenatal MR imaging findings with postnatal chronic lung disease. Radiology. 266(3):887-95, 2013
Jani JC et al: Lung-to-head ratio: a need to unify the technique. Ultrasound Obstet Gynecol. 39(1):2-6, 2012
Mehollin-Ray AR et al: Fetal MR imaging of congenital diaphragmatic hernia. Radiographics. 32(4):1067-84, 2012
Alfaraj MA et al: Congenital diaphragmatic hernia: lung-to-head ratio and lung volume for prediction of outcome. Am J Obstet Gynecol. 205(1):43.e1-8, 2011
Knox E et al: Prenatal detection of pulmonary hypoplasia in fetuses with congenital diaphragmatic hernia: a systematic review and meta-analysis of diagnostic studies. J Matern Fetal Neonatal Med. 23(7):579-88, 2010
Laudy JA et al: Congenital diaphragmatic hernia: an evaluation of the prognostic value of the lung-to-head ratio and other prenatal parameters. Prenat Diagn. 23(8):634-9, 2003
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