Meike Weidner, Presenter: Nothing to Disclose

Frank G. Zoellner, Abstract Co-Author: Nothing to Disclose

Claudia Hagelstein MD, Abstract Co-Author: Nothing to Disclose

Stefan Oswald Schoenberg MD, PhD, Abstract Co-Author: Institutional research agreement, Siemens AG

Katrin Zahn, Abstract Co-Author: Nothing to Disclose

Thomas Schaible, Abstract Co-Author: Nothing to Disclose

Wolfgang Neff MD, PhD, Abstract Co-Author: Nothing to Disclose

In severe cases of congenital diaphragmatic hernia (CDH), extracorporeal membrane oxygenation (ECMO) therapy is required. Later on, lung morbidity defines development. Lung function measurement is therefore crucial but limited in 2-year old children. With MRI, lung perfusion can be measured and is known to be reduced on the ipsilateral side after CDH. In this study we investigated if 2-year old children after ECMO-therapy show reduced MR-perfusion values as a sign of more severe lung hypoplasia in comparison to children without ECMO-requirement.

DCE-MRI was performed in 38 children (24.3±1.8 month; 15 with ECMO-therapy; 23 without ECMO-therapy) after CDH repair using a 3D TWIST sequence (temporal resolution 1.5 sec ; voxel size: 2x2x2 mm³). 0.05 mmol/kg body weight of contrast agent (Dotarem, Guerbet, France) was administered. Pulmonary blood flow (PBF), pulmonary blood volume (PBV) and mean transit time (MTT) were calculated for both lung sides by placing 6 cylindrical regions of interest (ROI) in the apical, middle and basal lung respectively. Additionally, the ratio of contralateral to ipsilateral lung was calculated for all parameters.

15 of 38 children (39%) required ECMO-therapy as neonates. In all children, PBF and PBV were significantly reduced on the ipsilateral side in comparison to the contralateral side (p always <0.05). Children after ECMO-therapy showed significantly reduced PBF and PBV-values on the ipsilateral side in comparison to children without ECMO therapy (e.g. PBFipsilateral(ECMO) 66±25 ml/100ml/min vs. PBFipsilateral(no ECMO) 106±53 ml/100ml/min; p=0.01). The ratio of contralateral/ipsilateral lung of PBF and PBV was significantly higher after ECMO-therapy. Perfusion values of the contralateral lungs did not differ significantly.

2-year old children after ECMO-requirement as neonates show significantly reduced MR perfusion values on the ipsilateral lung in comparison to children without ECMO-requirement. Perfusion values of the contralateral lung are not significantly different. MR perfusion measurements therefore reflect the severity of lung hypoplasia and are helpful in follow-up investigations.

MR-perfusion values reflect the severity of lung hypoplasia after CDH as children after ECMO-therapy show more reduced values. Therefore, MR-perfusion measurements are advisable for follow-up.

Weidner, M, Zoellner, F, Hagelstein, C, Schoenberg, S, Zahn, K, Schaible, T, Neff, W, MR Lung Perfusion in 2-year old Children After Congenital Diaphragmatic Hernia — Comparison of Children after ECMO-therapy and Children without ECMO-requirement.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14010119.html