fetal thorax

Question 1

herniation of the abdominal viscera into the fetal chest is a result of a congenital defect called?

Answer 1

congenital diaphragmatic hernia

Question 2

what side does a congenital diaphragmatic herniation occur on? & is it usually anterior or posterior?

Answer 2

left ; posterior

Question 3

what are the 2 forms of diaphragmatic herniation?

Answer 3

bochdalek hernia

morgagni’s hernia

Question 4

morgagni’s hernia is the most common presentation

true/false

Answer 4

false; very rare in occurance

Question 5

what is the sonographic appearance of a diaphragmatic herniation?

Answer 5

• displaced heart (to the right)
• cystic mass (stomach) in thorax if left sided
• absence of intraabdominal stomach
• hypoechoic or cystic structures representing bowel in chest
• liver may herniate if a right-sided herniation is present

Question 6

what other abnormalities are associated with diaphragmatic herniation?

Answer 6

• pulmonary hypoplasia (lungs unable to inflate)
• other congenital abnormalitites
- chromosomal
- cranial/spinal cord & cardiac abnormalities

Question 7

what is fetal hydrothorax?

Answer 7

an accumulation of fluid in the pleural cavity

Question 8

what is fetal hydrothorax also known as?

Answer 8

pleural effusion

Question 9

what other abnormalities are commonly associated with fetal hydrothorax?

Answer 9

• hydrops fetalis (immune & nonimmune)
• congestive heart failure
• chromosomal abnormalities
• chylothorax (accumulation of lymph fluid)
• compression of lung tissue may cause pulmonary hypoplasia

Question 10

what is the sonographic appearance of fetal hydrothorax?

Answer 10

• anechoic areas in one or both sides of the chest
• slight to moderate amounts of fluid will conform to the contours of the chest cavity
• severe effusions may compress lungs, displace the heart, & occupy the entire chest cavity

Question 11

what does CAM stand for?

Answer 11

cystic adenomatoid malformation

Question 12

CAM is a malignant tumor of the lung

true/false

Answer 12

false; benign

Question 13

what is CAM?

Answer 13

multicystic mass w/in the lung consiting of primitive lung tissue & abnormal bronchial & bronchiolar like structures that is usually unilateral & affects a single lobe.

Question 14

there are 3 different classifications for diagnosing CAM. how is it determined?

Answer 14

size & if it’s a single or multiple cysts

Question 15

a 26wk fetus presents with a singular cystic mass present in the right lung that is 5cm. what classification of CAM would this be?

Answer 15

Type 1

Question 16

you’re performing an anatomy scan on an 18wk fetus & notice mutiple small cysts in the left lobe when assessing for fetal heart tones. the biggest one measures to be 8mm. what classification of CAM would this be?

Answer 16

type 2

Question 17

what is the sonographic appearance of type 3?

Answer 17

• multiple tiny, non-visible cysts resulting in a bulky, hyperechoic appearance.
• appears as a solic mass

Question 18

what are some associated findings with CAM?

Answer 18

• polyhydramnios
• mediastinal shift
• hydrops fetalis

Question 19

what is bronchopulmonary sequestration?

Answer 19

pulmonary lesion compromised of lung tissue that is separated from normal tracheobronchial tree

Question 20

what is the sonographic appearance of bronchopulmonary sequestration?

Answer 20

echogenic mass at the base of the lung

may be triangular in shape

Question 21

what are some differential diagnoses for brochopulmonary sequestration?

Answer 21

CAM

teratoma

Question 22

what is the incomplete or insufficient development of the lungs?

Answer 22

pulmonary hypoplasia

Question 23

what causes pulmonary hydrops?

Answer 23

a decrease in the number of lung cells, airways, & alveoli, w/ a resulting decrease in organ size & weight

Question 24

what factors are associated w/ NORMAL lung growth?

Answer 24

fetal breathing movements
adequate thoracic space
adequate amniotic fluid
lung fluid

Question 25

what are some factors associated w/ ABNORMAL lung growth?

Answer 25

phrenic nerve agenesis (diaphragm not moving)
oligohydramnios
other anomalies
mass effect
- diaphragmatic herniation
- CAM
- pleural effusion