Radiology, Vol 200, 219-223, Copyright © 1996 by Radiological Society of North America
Neonates with congenital diaphragmatic hernia: radiographic findings during partial liquid ventilation
KA Garver, EA Kazerooni, RB Hirschl and MA DiPietro
Department of Radiology, C.S. Mott Children's Hospital, University of Michigan Medical Center, Ann Arbor 48109-0252, USA.
PURPOSE: To determine the serial radiographic appearance of the lungs of
neonates who underwent partial liquid ventilation with perflubron because
of congenital diaphragmatic hernia (CDH) or primary pulmonary hypertension.
MATERIALS AND METHODS: Bedside anteroposterior (AP) and lateral chest
radiographs (n = 235) were scored for percentage of lung opacification by
perflubron during partial liquid ventilation (PLV) and extracorporeal
membrane oxygenation (ECMO). Five neonates participated in the study; four
had CDH, and one had primary pulmonary hypertension. RESULTS: The lungs
were opacified nearly completely after each dose of perflubron. The degree
of opacification was the same on 117 of 169 (69%) AP radiographs and within
one point on another 40 (24%). A gravity-dependent distribution was shown
on 58 of 66 (88%) lateral radiographs. A minimal amount of perflubron
remained in the lungs after 5.2 days. A hypoplastic bronchus and
ipsilateral lung were manifest in all four of the patients with CDH after
the airway and lung were filled with radiopaque perflubron. CONCLUSION:
Lungs filled with perflubron were opacified to a similar degree in a
gravity-dependent distribution. Evaporation of perflubron from the lungs of
neonates is relatively rapid. The size of the ipsilateral bronchus and lung
may be estimated by comparison of radiographs taken before and after the
lungs were filled with perflubron.
