1) Review the prenatal US appearance of thoracic anomalies. 2) Understand the role of fetal MRI as an adjunct in the evaluation of chest abnormalities. 3) Correlate prenatal evaluation with postnatal diagnosis and outcome.
Advances in US and fetal MRI have changed the practice of obstetrics in the assessment of fetal intrathoracic structures. More accurate prenatal diagnosis has increased options for pregnancy management. US advances have increased the rate of chest anomaly detection. MRI is a complementary tool in the assessment of chest anomalies due to its exquisite delineation of the airway and lung parenchyma. Various anomalies can be identified within the fetal chest. Anomalies include congenital bronchopulmonary malformations (BPM;s), pleural effusions, congenital diaphragmatic hernia, congenital high airway obstruction (CHAOS) and pulmonary hypoplasia/ agenesis. Congenital BPM;s represent the largest group of lung anomalies that include congenital pulmonary airway malformation (CPAM), bronchopulmonary sequestration (BPS), and congenital lobar overinflation (CLO). BPMs are thought to represent a spectrum of anomalies that result from airway obstruction malformation sequences the end result dependent on the timing and severity of airway obstruction. Congenital pulmonary airway malformation (CPAM), previously known as congenital cystic adenomatoid malformation (CCAM), is a hamartomatous lung lesion with abnormal bronchioles that communicate with the tracheobronchial tree. BPS are nonfunctioning lung tissue with no communication to the bronchial tree that are supplied by systemic arteries. BPS are often hybrid lesions with both sequestration and CPAM components. CLO, also known as congenital lobar emphysema, has normal lung parenchyma with normal vascularity that is hyperinflated. The outcome of these lesions is variable with the development of hydrops a poor prognostic indicator. Accurate prenatal diagnosis is fundamental to assess prognosis, counsel appropriately, plan prenatal/delivery management and postnatal care
Bulas, D,
Fetal Imaging Evaluation of Thoracic Anomalies. Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL.
http://archive.rsna.org/2011/11000757.html
