Imaging recommendation · Chest

Prenatal or neonatal respiratory distress with chest mass on CXR, suspected congenital diaphragmatic hernia

Q: What's the alternative imaging for prenatal or neonatal respiratory distress with chest mass on cxr, suspected congenital diaphragmatic hernia when postnatal characterization?

XR — CXR + abdominal X-ray (bowel in chest) (no contrast).

Recommended: Prenatal US + Fetal MRI + Postnatal CXR is the preferred imaging study for prenatal or neonatal respiratory distress with chest mass on cxr, suspected congenital diaphragmatic hernia. Bochdalek (posterolateral, left > right, 90%); Morgagni (anteromedial, less common).

Recommended study

Prenatal US + Fetal MRI + Postnatal CXR

MRI No contrast Preferred Chest Acute inpatient Reviewed 2026-05

Bochdalek (posterolateral, left > right, 90%); Morgagni (anteromedial, less common). Lung hypoplasia is main morbidity driver.

If the default doesn't apply

Postnatal characterization

XR CXR + abdominal X-ray (bowel in chest) No contrast

Watch-outs

Pulmonary hypoplasia + hypertension

Drives outcome; ECMO sometimes required for severe cases.

Pearls

Lung-to-head ratio (LHR) on prenatal US predicts outcome.
Fetal endoluminal tracheal occlusion (FETO) in severe cases.
Postnatal: stabilize first (gentle ventilation, often ECMO), then operate.