title: Imaging findings in fetal diaphragmatic abnormalities.
abstract: Imaging plays a key role in the detection of a diaphragmatic pathology in utero. US is the screening method, but MRI is increasingly performed. Congenital diaphragmatic hernia is by far the most often diagnosed diaphragmatic pathology, but unilateral or bilateral eventration or paralysis can also be identified. Extralobar pulmonary sequestration can be located in the diaphragm and, exceptionally, diaphragmatic tumors or secondary infiltration of the diaphragm from tumors originating from an adjacent organ have been observed in utero. Congenital abnormalities of the diaphragm impair normal lung development. Prenatal imaging provides a detailed anatomical evaluation of the fetus and allows volumetric lung measurements. The comparison of these data with those from normal fetuses at the same gestational age provides information about the severity of pulmonary hypoplasia and improves predictions about the fetus's outcome. This information can help doctors and families to make decisions about management during pregnancy and after birth. We describe a wide spectrum of congenital pathologies of the diaphragm and analyze their embryological basis. Moreover, we describe their prenatal imaging findings with emphasis on MR studies, discuss their differential diagnosis and evaluate the limits of imaging methods in predicting postnatal outcome.
authors.affiliation: Unit of Radiopediatrics, Department of Radiology, University Hospital Center of Lausanne, Lausanne, Switzerland. leonor.alamo@chuv.ch.
authors.forename: Leonor
authors.initials: L
authors.lastname: Alamo
authors.affiliation: Unit of Radiopediatrics, Department of Radiology, University Hospital Center of Lausanne, Lausanne, Switzerland.
authors.forename: François
authors.initials: F
authors.lastname: Gudinchet
authors.affiliation: Department of Radiology, University Hospital Center of Lausanne, Lausanne, Switzerland.
authors.forename: Reto
authors.initials: R
authors.lastname: Meuli
mesh_terms: D003937:Diagnosis, Differential; D003952:Diagnostic Imaging; D003964:Diaphragm / Q000002:abnormalities*; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis*; D006801:Humans; D008168:Lung / Q000002:abnormalities; D008279:Magnetic Resonance Imaging; D011247:Pregnancy; D011296:Prenatal Diagnosis; D016216:Ultrasonography, Prenatal
keywords: Congenital abnormality; Diaphragm; Fetus; Magnetic resonance imaging; Prenatal diagnosis; Ultrasound