Case challenge · Imaging / Fetal medicine / Pediatric surgery · teaching

Congenital Diaphragmatic Hernia (CDH) Fetal MRI · case challenge

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← View the full flowchartBased on Fetal lung volume assessment

Case #1Imaging / Fetal medicine / Pediatric surgery

📋 Case data

Lung volume/liver position assessmento/e LHR >45% or o/e TFLV >45%, liver in the abdomen (liver down)

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Step 1 / 1 · Lung volume/liver position assessment

Lung volume (o/e LHR, o/e TFLV) and liver position (mostly left CDH)?

💡 Fetal MRI can distinguish liver/lung/bowel and estimate residual lung volume. Prognostic parameters: o/e LHR (ultrasound lung-to-head ratio, ~22 weeks+), o/e TFLV (MRI total fetal lung volume), liver position (liver herniated into the chest, liver up, is worse, raising ECMO/pulmonary hypertension), stomach position. MRI also differentiates pulmonary sequestration/thoracic masses.

For teaching. Decisions and their basis are taken from this site's reviewed care pathways; for licensed clinicians/trainees, this does not replace clinical judgment or local protocols.