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Thorax

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Ultraschalldiagnostik in Geburtshilfe und Gynäkologie

Zusammenfassung

Verschiebungen des Größenverhältnisses zwischen Herz und Lungen sowie die Verlagerung von Herz und Mediastinum sind häufig Ausdruck einer intrathorakalen Pathologie oder eines Zwerchfelldefekts. Zu den häufigsten Lungenfehlbildungen gehören bronchopulmonale Anomalien (z. B. CCAML), vaskuläre Anomalien und kombinierte Anomalien von Lunge und Gefäßsystem (z. B. Sequestration). Thorakale Anomalien können zu einer Lungenhypoplasie und damit zu einer erhöhten postnatalen Morbidität und Mortalität führen. Die häufigste intrathorakale Ursache der Lungenhypoplasie ist die fetale Zwerchfellhernie, andere intrathorakale Ursachen sind ein ausgeprägter Hydrothorax, die CCAML oder ein Lungensequester. Die Entbindung von Kindern mit diesen Krankheitsbildern sollte immer am Perinatalzentrum erfolgen, da viele der Neugeborenen symptomatisch sind und eine entsprechende neonatologische Intensivtherapie bis hin zur sofortigen kinderchirurgischen Intervention benötigen.

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Literatur

  • Berg C, Geipel A, Germer U, Petersen-Hansen A, Koch-Dörfler M, Gembruch U (2001) Prenatal detection of Fraser syndrome without cryptophthalmos: case report and review of the literature. Ultrasound Obstet Gynecol 18: 76–80

    Google Scholar 

  • Bermúdez C, Pérez-Wulff J, Bufalino G, Sosa C, Gómez L, Quintero RA (2007) Precutaneous ultrasound-guided sclerotherapy for complicated fetal intralobar bronchopulmonary sequestration. Ultrasound Obstet Gynecol 29: 586–589

    Google Scholar 

  • Bernasconi A, Yoo SJ, Golding F, Langer JC, Jaeggi ET (2007) Etiology and outcome of prenatally detected paracardial cystic lesions: a case series and review of the literature. Ultrasound Obstet Gynecol 29: 388–394

    Google Scholar 

  • Bhide A, Murphy D, Thilaganathan B, Carvalho JS (2010) Prenatal findings and differential diagnosis of scimitar syndrome and pulmonary sequestration. Ultrasound Obstet Gynecol 35: 398–404

    Google Scholar 

  • Biyyam R, Chapman T, Ferguson MR, Deutsch G, Dighe MK (2010) Congenital lung abnormailities: Embryologic features, prenatal diagnosis, and postnatal radiologic-pathologic correlation. Radiographics 30: 1721–1738

    Google Scholar 

  • Cannie M, Jani J, Chaffiotte C, Vaast P, Deruelle P, Houfflin-Debarge V, Dymarkowski S, Deprest J (2008a) Quantification of intrathoracic liver herniation by magnetic resonance imaging and prediction of postnatal survival in fetuses with congenital diaphragmatic hernia. Ultrasound Obstet Gynecol 32: 627–632

    Google Scholar 

  • Cannie M, Jani J, Meersschaert J, Allegaert K, Done E, Marchal G, Deprest J, Dymarkowski S (2008b) Prenatal prediction of survival in isolated diaphragmatic hernia using observed to expected total fetal lung volume determined by magnetic resonance imaging based on either gestational age or fetal body volume. Ultrasound Obstet Gynecol 32: 633–639

    Google Scholar 

  • Cannie MM, Jani JC, Van Kerkhove F, Meerschaert J, De Keyzer F, Lewi L, Deprest JA, Dymarkowski S (2008c) Fetal body volume at MR imaging to quantify total fetal lung volume: normal ranges. Radiology 247: 197–203

    Google Scholar 

  • Cannie MM, Jani JC, De Keyzer F, Allegaert K, Dymarkowski S, Deprest J (2009) Evidence and patterns in lung response after fetal tracheal occlusion: clinical controlled study. Radiology 252: 526–533

    Google Scholar 

  • Cass DL, Olutoye OO, Cassady CL, Moise KJ, Johnson A, Papanna R, Lazar DA, Ayres NA, Belleza-Bascon B (2011) Prenatal diagnosis and outcome of fetal lung masses. J Pediatr Surg 46: 292–298

    Google Scholar 

  • Caserío S, Gallego C, Martin P, Moral MT, Pallás CR, Galindo A (2010) Congenital chylothorax: from foetal life to adolescence. Acta Paediatr 99: 1571–1577

    Google Scholar 

  • Cavoretto P, Molina F, Poggi S, Davenport M, Nicolaides KH (2008) Prenatal diagnosis and outcome of echogenic fetal lung lesions. Ultrasound Obstet Gynecol 32: 769–783

    Google Scholar 

  • Chen CP (2007) Syndromes and disorders associated with omphalocele (II): OEIS complex and pentalogy of cantrell. Taiwan J Obstet Gynecol 46: 103–110

    Google Scholar 

  • Chitkara U, Rosenberg J, Chervenak FA, Berkowitz GS, Levine R, Fagerstom RM, Walker B, Berkowitz RL (1987) Prenatal sonographic assessment of the fetal thorax: normal values. Am J Obstet Gynecol 156: 1069–1074

    Google Scholar 

  • Claus F, Sandaite I, DeKoninck P, Moreno O, Cruz Martinez R, Van Mieghem T, Gucciardo L, Richter J, Michielsen K, Decraene J, Devlieger R, Gratacos E, Deprest J (2011) Prenatal anatomical imaging in fetuses with congenital diaphragmatic hernia. Fetal Diagn Ther 29: 88–100

    Google Scholar 

  • Cottin V, Dupuis-Girod S, Lesca G, Cordier JF (2007) Pulmonary vascular manifestations of hereditary hemorrhagic telangiectasia osler disease. Respiration 74: 361–378

    Google Scholar 

  • Crombleholme TM, Coleman B, Hedrick H, Liechty K, Howell L, Flake AW, Johnson M, Adzick NS (2002) Cystic adenomatoid malformation volume ratio predicts outcome in prenatally diagnosed cystic adenomatoid malformation of the lung. J Pediatr Surg 37: 331–338

    Google Scholar 

  • Cruz-Martinez R, Méndez A, Dueñas-Riaño J, Ordorica-Flores R, Nieto-Zermeño J, Malagón-Salazar P, Medina-Noyola C, Rebolledo-Fernández C (2015) Fetal laser surgery prevents fetal death and avoids the need for neonatal sequestrectomy in cases with bronchopulmonary sequestration. Ultrasound Obstet Gynecol 46: 627–628

    Google Scholar 

  • Curran PF, Jelin EB, Rand L, Hirose S, Feldstein VA, Goldstein RB, Lee H (2010) Prenatal steroids for microcystic congenital cystic adenomatoid malformations. J Pediatr Surg 45: 145–150

    Google Scholar 

  • DeKoninck P, Gomez O, Sandaite I, Richter J, Nawapun K, Eerdekens A, Ramirez JC, Claus F, Gratacos E, Deprest J (2015) Right-sided congenital diaphragmatic hernia in a decade of fetal surgery. BJOG 122: 940–946

    Google Scholar 

  • Deprest JA, Flemmer AW, Gratacos E, Nicolaides K (2009) Antenatal prediction of lung volume and in-utero treatment by fetal endoscopic tracheal occlusion in severe isolated congenital diaphragmatic hernia. Semin Fetal Neonatal Med 14: 8–13

    Google Scholar 

  • Deprest J, Kypros N, Done E, Lewi P, Barki G, Largen E, DeKoninck P, Sandaite I, Ville Y, Benachi A, Jani J, Amat-Roldan I, Gratacos E (2011) Technical aspects of fetal endoscopic tracheal occlusion for congenital diaphragmatic hernia. J Pediatr Surg 46: 22–32

    Google Scholar 

  • Deprest J, Brady P, Nicolaides K, Benachi A, Berg C, Vermeesch J, Gardener G, Gratacos E (2014) Prenatal management of the fetus with isolated congenital diaphragmatic hernia in the era of the TOTAL trial. Semin Fetal Neonatal Med 19: 338–48

    Google Scholar 

  • Doné E, Gucciardo L, Van Mieghem T, Jani J, Cannie M, Van Schoubroeck D, Devlieger R, De Catte L, Klaritsch P, Mayer S, Beck V, Debeer A, Gratacos E, Nicolaides K, Deprest J (2008) Prenatal diagnosis, prediction of outcome and in utero therapy of isolated congenital diaphragmatic hernia. Prenat Diagn 28: 581–591

    Google Scholar 

  • Grethel E, Hornbeger L, Farmer D (2007) Prenatal and postnatal management of a patient with pentalogy of Cantrell and left ventricular aneurysm. Fetal Diagn Ther 22: 269–273

    Google Scholar 

  • Harrison MR, Adzick NS, Bullard KM, et al (1997) Correction of congenital diaphragmatic hernia in utero: VII. A prospective trial. J Pediatr Surg 32: 1637–1642

    Google Scholar 

  • Hedrick HL (2010) Management of prenatally diagnosed congenital diaphragmatic hernia. Semin Fetal Neonatal Med 15: 21–27

    Google Scholar 

  • Hedrick MH, Ferro MM, Filly RA, Flake AW, Harrison MR, Adzick NS (1994) Congenital high airway obstruction syndrome (CHAOS): a potential for perinatal intervention. J Pediatr Surg 29: 271–274

    Google Scholar 

  • Heling KS, Tennsted C, Chaoui R, Kalache KD, Hartung J, Bollmann R (2001) Reliability of prenatal sonographic lung biometry in the diagnosis of pulmonary hypoplasia. Prenat Diagn 21: 649–657

    Google Scholar 

  • Hellmund A, Berg C, Bryan C, Schneider M, Hraška V, Gembruch U (2014) Large fetal pulmonary arteriovenous malformation detected at midtrimester scan with subsequent high cardiac output syndrome and favorable postnatal outcome. Fetal Diagn Ther 35: 133–136

    Google Scholar 

  • Hellmund A, Berg C, Geipel A, Bludau M, Heydweiller A, Bachour H, Müller A, Müller A, Gembruch U (2016) Prenatal diagnosis and evaluation of sonographic predictors for intervention and adverse outcome in congenital pulmonary airway malformation. PLoS One 11: e0150474

    Google Scholar 

  • Ierullo AM, Ganapathy R, Crowley S, Craxford L, Bhide A, Thilaganathan B (2005) Neonatal outcome of antenatally diagnosed congenital cystic adenomatoid malformations. Ultrasound Obstet Gynecol 26: 150–153

    Google Scholar 

  • Illanes S, Hunter A, Evans M, Cusick E, Soothill P (2005) Prenatal diagnosis of echogenic lung: evolution and outcome. Ultrasound Obstet Gynecol 26: 150–153

    Google Scholar 

  • Jani J, Nicolaides KH, Keller RL, Benachi A, Peralta CFA, Favre R, Moreno O, Tibboel D, Lipitz S, Eggink A, Vaast P, Allegaert K, Harrison M, Deprest J, Antenatal-CDH-Registry group (2007a) Observed to expected lung area to head circumference ratio in the prediction of survival in fetuses with isolated diaphragmatic hernia. Ultrasound Obstet Gynecol 30: 67–71

    Google Scholar 

  • Jani JC, Peralta CFA, Ruano R, Benachi A, Done E, Nicolaides KH, Deprest JA (2007b) Comparison of fetal lung area to head circumference ratio with lung volume in the prediction of postnatal outcome in diaphragmatic hernia. Ultrasound Obstet Gynecol 30: 850–854

    Google Scholar 

  • Jani J, Cannie M, Sonigo P, Robert Y, Moreno O, Benachi A, Vaast P, Gratacos E, Nicolaides KH, Deprest J (2008) Value of prenatal magnetic resonance imaging in the prediction of postnatal outcome in fetuses with diaphragmatic hernia. Ultrasound Obstet Gynecol 32: 793–799

    Google Scholar 

  • Jani JC, Nicolaides KH, Gratacós E, Valencia CM, Doné E, Martinez JM, Gucciardo L, Cruz R, Deprest JA (2009) Severe diaphragmatic hernia treated by fetal endoscopic tracheal occlusion. Ultrasound Obstet Gynecol 34: 304–310

    Google Scholar 

  • Jeong BD, Won HS, Lee MY, Shim JY, Lee PR, Kim A (2015) Perinatal outcomes of fetal pleural effusion following thoracoamniotic shunting. Prenat Diagn 35 : 1365–1370

    Google Scholar 

  • Kalache KD, Chaoui R, Tennstedt C, Bollmann R (1997) Prenatal diagnosis of laryngeal atresia in two cases of congenital high airway obstruction syndrome (CHAOS). Prenat Diagn 17: 577–581

    Google Scholar 

  • Kalache KD, Espinoza J, Chaiworapongsa T, Londono J, Schoen ML, Treadwell MC, Lee W, Romero R (2003) 3D ultrasound fetal lung volume measurement: a systematic study comparing the multiplanar technique with the rotational (VOCAL) technique. Ultrasound Obstet Gynecol 21: 111–118

    Google Scholar 

  • Kilian AK, Büsing KA, Schuetz EM, Schaible T, Neff KW (2009) Fetal MR lung volumetry in congenital diaphragmatic hernia (CDH): Prediction of clinical outcome and the need for extracorporeal membrane oxygenation (ECMO). Klin Padiatr 221: 295–301

    Google Scholar 

  • Klam S, Bigras JL, Hudon L (2005) Predicting outcome in primary fetal hydrothorax. Fetal Diagn Ther 20: 366–370

    Google Scholar 

  • Kunisaki SM, Fauza DO, Nemes LP, Barnewolt CE, Estroff JA, Kozakewich HP, Jennings RW (2006) Bronchial atresia: the hidden pathology within a spectrum of prenatally diagnosed lung masses. J Pediatr Surg 41: 61–65

    Google Scholar 

  • Lee KA, Cho JY, Lee SM, Jun JK, Kang J, Seo JW (2010) Prenatal diagnosis of bilateral pulmonary agenesis: a case report. Korean J Radiol 11: 119–122

    Google Scholar 

  • Mallmann MR, Geipel A, Bludau M, Matil K, Gottschalk I, Hoopmann M, Müller A, Bachour H, Heydweiller A, Gembruch U, Berg C (2014) Bronchopulmonary sequestration with massive pleural effusion: pleuroamniotic shunting vs intrafetal vascular laser ablation. Ultrasound Obstet Gynecol 44: 441–446

    Google Scholar 

  • Mallmann MR, Graham V, Rösing B, Gottschalk I, Müller A, Gembruch U, Geipel A, Berg C (2016) Thoracoamniotic Shunting for Fetal Hydrothorax: Predictors of Intrauterine Course and Postnatal Outcome. Fetal Diagn Ther [epub ahead of print] PMID: 27174294

    Google Scholar 

  • Martínez JM, Castañón M, Gómez O, Prat J, Eixarch E, Bennasar M, Puerto B, Gratacós E (2013) Evaluation of fetal vocal cords to select candidates for successful fetoscopic treatment of congenital high airway obstruction syndrome: preliminary case series. Fetal Diagn Ther 34: 77–84

    Google Scholar 

  • Meller CH, Morris RK, Desai T, Kilby MD (2012) Prenatal diagnosis of isolated right pulmonary agenesis using sonography alone: case study and systematic literature review. J Ultrasound Med 31: 2017–2023

    Google Scholar 

  • Moessinger AC, Santiago A, Paneth NS, Rey HR, Blanc WA, Driscoll jr JM (1989) Time-trends in necropsy prevalence and birthprevalence of lung hypoplasia. Paediatr Perinat Epidemiol 3: 421–431

    Google Scholar 

  • Mullassery D, Ba’ath ME, Jesudason EC, Losty PD (2010) Value of liver herniation in prediction of outcome in fetal congenital diaphragmatic hernia: a systematic review and meta-analysis. Ultrasound Obstet Gynecol 35: 609–614

    Google Scholar 

  • Peralta CFA, Cavoretto P, Csapo B, Falcon O, Nicolaides KH (2006) Lung and heart volumes by three-dimensional ultrasound in normal fetuses at 12–32 weeks’ gestation. Ultrasound Obstet Gynecol 27: 128–133

    Google Scholar 

  • Peralta CF, Cavoretto P, Csapo B, Vandecruys H, Nicolaides KH (2005) Assessment of lung area in normal fetuses at 12–32 weeks. Ultrasound Obstet Gynecol 26: 718–724

    Google Scholar 

  • Picone O, Benachi A, Mandelbrot L, Ruano R, Dumez Y, Dommergues M (2004) Thoracoamniotic shunting for fetal pleural effusions with hydrops. Am J Obstet Gynecol 191: 2047–2050

    Google Scholar 

  • Roybal JL, Liechty KW, Hedrick HL, Bebbington MW, Johnson MP, Coleman BG, Adzick NS, Flake AW (2010) Predicting the severity of congenital high airway obstruction syndrome. J Pediatr Surg 45: 1633–1639

    Google Scholar 

  • Rustico MA, Lanna M, Coviello D, Smoleniec J, Nicolini U (2007) Fetal pleural effusion. Prenat Diagn 27: 793–799

    Google Scholar 

  • Ruano R, Yoshisaki CT, da Silva MM, Ceccon ME, Grasi MS, Tannuri U, Zugaib M (2012) A randomized controlled trial of fetal endoscopic tracheal occlusion versus postnatal management of severe isolated congenital diaphragmatic hernia. Ultrasound Obstet Gynecol 39: 20–27

    Google Scholar 

  • Sandaite I, Claus F, De Keyzer F, Donè E, Van Mieghem T, Gucciardo L, DeKoninck P, Jani J, Cannie M, Deprest JA (2011) Examining the relationship between the lung-to-head ratio measured on ultrasound and lung volumetry by magnetic resonance in fetuses with isolated congenital diaphragmatic hernia. Fetal Diagn Ther 29: 80–87

    Google Scholar 

  • Schrey S, Kelly EN, Langer JC, Davies GA, Windrim R, Seaward PG, Ryan G (2012) Fetal thoracoamniotic shunting for large macrocystic congenital cystic adenomatoid malformations of the lung. Ultrasound Obstet Gynecol 39: 515–20

    Google Scholar 

  • Shanti CM, Klein MD (2008) Cystic lung disease. Semin Pediatr Surg 17: 2–8

    Google Scholar 

  • Sinha CK, Islam S, Patel S, Nicolaides K, Greenough A, Davenport M (2009) Congenital diaphragmatic hernia: prognostic indices in the fetal endoluminal tracheal occlusion era. J Pediatr Surg 44: 312–316

    Google Scholar 

  • Staboulidou I, Wüstemann M, Schmidt P, Günter HH, Scharf A (2005) Increased fetal nuchal translucency as a predictor of Cantrell’s pentology-case report. Z Geburtshilfe Neonatol 209: 231–234

    Google Scholar 

  • Stanton M, Njere I, Ade-Ajayi N, Patel S, Davenport M (2009) Systematic review and meta-analysis of the postnatal management of congenital cystic lung lesions. J Pediatr Surg 44: 1027–1033

    Google Scholar 

  • Stocker JT, Madewell JE, Drake RM (1977) Congenital cystic adenomatoid malformation of the lung. Classification and morphologic spectrum. Hum Pathol 8: 155–171

    Google Scholar 

  • Stocker JT (2002) Congenital pulmonary airway malformation: a new name for and an expanded classification of congenital cystic adenomatoid malformation of the lung. Histopathology 41: 424–430

    Google Scholar 

  • Vidaeff AC, Szmuk P, Mastrobattista JM, Rowe TF, Ghelber O (2007) More or less CHAOS: case report and literature review suggesting the existence of a distinct subtype of congenital high airway obstruction syndrome. Ultrasound Obstet Gynecol 30: 114–117

    Google Scholar 

  • Valfré L, Braguglia A, Conforti A, Morini F, Trucchi A, Iacobelli BD, Nahom A, Chukhlantseva N, Dotta A, Corchia C, Bagolan P (2011) Long term followup in high-risk congenital diaphragmatic hernia survivors: patching the diaphragm affects the outcome. J Pediatr Surg 46: 52–56

    Google Scholar 

  • Waller K, Chaithongwongwatthana S, Yamasmit W, Donnenfeld AE (2005) Chromosomal abnormalities among 246 fetuses with pleural effusions detected on prenatal ultrasound examination: Factors associated with an increased risk of aneuploidy. Genet Med 7: 417–421

    Google Scholar 

  • Weidner M, Hagelstein C, Debus A, Walleyo A, Weiss C, Schoenberg SO, Schaible T, Büsing KA, Kehl S, Neff KW (2014) MRI-based ratio of fetal lung volume to fetal body volume as a new prognostic marker in congenital diaphragmatic hernia. Am J Roentgenol 202: 1330–1336

    Google Scholar 

  • Witlox RS, Lopriore E, Oepkes D (2011) Prenatal interventions for fetal lung lesions. Prenat Diagn 31: 628–636

    Google Scholar 

  • Wong A, Vieten D, Singh S, Harvey JG, Holland AJ (2009) Long-term outcome of asymptomatic patients with congenital cystic adenomatoid malformation. Pediatr Surg Int 25: 479–485

    Google Scholar 

  • Yinon Y, Grisaru-Granovsky S, Chaddha V, Windrim R, Seaward PGR, Kelly EN, Beresovska O, Ryan G (2010) Perinatal outcome following fetal chest shunt insertion for pleural effusion. Ultrasound Obstet Gynecol 36: 58–64

    Google Scholar 

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  1. Universitätsklinikum Bonn, Abt. für Geburtshilfe/Pränatale Medizin, Sigmund-Freud-Str. 25, 53105, Bonn, Deutschland

    Prof. Dr. med. A. Geipel

  2. Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Geburtshilfe, Martinistraße 52, 20246, Hamburg, Deutschland

    Prof. Dr. med. K. Hecher

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  1. Prof. Dr. med. A. Geipel
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  1. Bonn, Deutschland

    Ulrich Gembruch

  2. Hamburg, Deutschland

    Kurt Hecher

  3. Salzburg, Austria

    Horst Steiner

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Geipel, A., Hecher, K. (2018). Thorax. In: Gembruch, U., Hecher, K., Steiner, H. (eds) Ultraschalldiagnostik in Geburtshilfe und Gynäkologie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-53662-9_9

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