Link: http://www.ncbi.nlm.nih.gov/pubmed/26451536

Pediatr Pulmonol. 2015 Oct 9. doi: 10.1002/ppul.23325. [Epub ahead of print]
Pulmonary ventilation and micro-structural findings in congenital diaphragmatic hernia.
Spoel M1, Marshall H2, IJsselstijn H1, Parra-Robles J2, van der Wiel E3, Swift AJ2, Rajaram S2, Tibboel D1, Tiddens HA3,4, Wild JM2.
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Abstract
BACKGROUND:
With increasing survival of patients with more severe forms of congenital diaphragmatic hernia (CDH) and risk of long-term respiratory morbidity, studies on lung morphology are needed. We used hyperpolarised 3 He MRI and anatomical 1 H MRI in a cohort of young adult CDH patients to image regional lung ventilation and microstructure, focusing on morphological and micro-structural (alveolar) abnormalities.

METHODS:
Nine patients with left-sided CDH, born 1975-1993, were studied. Regional ventilation was imaged with hyperpolarised 3 He MRI, and the 3 He apparent diffusion coefficient (ADC) was computed separately for the ipsilateral and contralateral lungs. 1 H MRI was used to image lung anatomy, total lung volume and motion during free-breathing.

RESULTS:
3 He MRI showed ventilation abnormalities in six patients, ranging from a single ipsilateral ventilation defect (3 patients) to multiple ventilation defects in both lungs (one patient treated with extra corporeal membrane oxygenation). In eight patients, 3 He ADC values for the ipsilateral lung were significantly higher than those for the contralateral lung.

CONCLUSIONS:
Functional and micro-structural changes persist into adulthood in most CDH patients. Ipsilateral elevated 3 He ADC values are consistent with enlargement of mean dimensions of the confining lung micro-structure at the alveolar level. Pediatr Pulmonol. 2015; 9999:1-10. ? 2015 Wiley Periodicals, Inc.

? 2015 Wiley Periodicals, Inc.

KEYWORDS:
MRI; alveolar structure; congenital diaphragmatic hernia; lung development; pulmonary ventilation