Abstract
To evaluate the effects of congenital dialphragmatic hemia (CDH) and pulmonary hypoplasia on subsequent lung development, we performed lung Xenon 133 ventilation and M.A.A. - Tc 99m perfusion scintigraphies (LVPS) in 16 patients (pts) 2-3 months of age who had had surgical repair of a left CDH within the first 12 hours of life. 10 of these 16 pts were reevaluated at 1-2 years and again at 5-6 years in 6 of them. On the initial lung scintigraphies, ventilation (V) to the hernia side was decreased in 8/16 pts and Δ[VR-VL] averaged 12.6 ± 13.7. In 9/16 pts, there was a trapping of Xenon 133 at the left lung base. Perfusion (P) to the hernia side was decreased in 11/16 pts and Δ[PR-PL] averaged 26.2 ± 23.2. Correlation between V and P was good : r = 0.70, p < 0.01. After 1 year, V to the hernia side became normal except in 2/10 pts (ΔV = 5.2 ± 4.9), but P to the hernia side remained low in 9/10 pts (ΔP = 21.2 ± 7.9). After 5 years, V was normal in all of the 6 pts studied (ΔV = 2.6 ± 3.1); however P to the hernia side was still reduced in 5/6 pts (ΔP = 18.6 ± 5.4). These results show a progressive inprovemsnt and normalization of V and a persisting reduction of P to the lung of the hernia side, suggesting a primary vascular pulmonary hypoplasia in CDH. LVPS is a unique ncn invasive method that provides quantitative and qualitative informations on P and V, which are very helpful in the follow-up of repaired CDH, during the first years of life when physiologic studies are most difficult to obtain.
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
Rights and permissions
About this article
Cite this article
Demarquez, J., Lambert, B., Lamireau, T. et al. LUNG VENTILATION AND PERFUSION SCINTIGRAPHY IN THE FOLLOW-UP OF REPAIRED CONGENITAL DIAPHRAGMATIC HERNIA. Pediatr Res 26, 508 (1989). https://doi.org/10.1203/00006450-198911000-00056
Issue date:
DOI: https://doi.org/10.1203/00006450-198911000-00056
