What is the role of imaging studies in the diagnosis of persistent pulmonary hypertension of the newborn (PPHN)?

Updated: Sep 03, 2019
  • Author: Kate A Tauber, MD; Chief Editor: Howard S Weber, MD, FSCAI  more...
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Answer

Answer

Chest radiography: To assess for presence of underlying parenchymal lung disease (eg, meconium aspiration syndrome, pneumonia, surfactant deficiency) and/or to exclude underlying disorders (eg, congenital diaphragmatic hernia); see the image below

Persistent pulmonary hypertension of the newborn ( Persistent pulmonary hypertension of the newborn (PPHN). Meconium aspiration in a neonate. This radiograph was obtained shortly after birth and shows ill-defined, predominantly perihilar opacities in the lungs; these are more severe on the right than on the left. The lungs are hyperexpanded. The neonate's heart size is within normal limits.

Echocardiography: To screen and assist in making the diagnosis of PPHN and to rule out a structural heart lesion

Echocardiography with Doppler and color-flow mapping: To assess presence/direction of the intracardiac shunt at the ductus arteriosus and foramen ovale, as well as estimate the pulmonary arterial systolic/diastolic pressures

Cranial ultrasonography: To assess for intraventricular bleeding and for peripheral areas of hemorrhage or infarct if ECMO is being considered

Cranial ultrasonography with Doppler flow: To assess whether a nonhemorrhagic infarct is present

Brain computed tomography scanning or magnetic resonance imaging: To evaluate for central nervous system injury


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