title: Lung ventilation and perfusion scintigraphy in the follow up of repaired congenital diaphragmatic hernia.
abstract: To evaluate the effects of congenital diaphragmatic hernia (CDH) and pulmonary hypoplasia on subsequent lung function and development, we performed lung 133Xe ventilation and 99mTc perfusion scintigraphies in a group of infants who had undergone surgical repair of a severe left CDH with respiratory distress within the first 6 h of life. The initial lung scans performed in 15 children, 2-3 months of age, demonstrated a decreased ventilation in 7. In 9 children there was a trapping of 133Xe at the left lung base. Perfusion to the hernia side was reduced in 8 of the children. We re-evaluated 11 of these 15 patients after 1-2 years. The ventilation to the left lung was still decreased in 3, but perfusion remained decreased in 9. After 5 years, ventilation to the hernia side was normal in 4 of the 5 patients studied, whereas pulmonary blood flow was abnormal in 4. These results show a progressive improvement of ventilation with a persisting reduction of perfusion to the lung of the hernia side, suggesting a primary vascular pulmonary hypoplasia in CDH.
authors.affiliation: Nuclear Medicine Department, Hôpital Universitaire Pellegrin, Bordeaux, France.
authors.forename: R
authors.initials: R
authors.lastname: Jeandot
authors.forename: B
authors.initials: B
authors.lastname: Lambert
authors.forename: A J
authors.initials: AJ
authors.lastname: Brendel
authors.forename: M
authors.initials: M
authors.lastname: Guyot
authors.forename: J L
authors.initials: JL
authors.lastname: Demarquez
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D006548:Hernia, Diaphragmatic / Q000503:physiopathology / Q000601:surgery; D065630:Hernias, Diaphragmatic, Congenital; D006801:Humans; D007231:Infant, Newborn; D008168:Lung / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008297:Male; D011877:Radionuclide Imaging; D013668:Technetium Tc 99m Aggregated Albumin; D014692:Ventilation-Perfusion Ratio / Q000502:physiology*; D014980:Xenon Radioisotopes
chemical_list: D013668:Technetium Tc 99m Aggregated Albumin; D014980:Xenon Radioisotopes