Using improved treatment strategies for patients with congenital diaphragmatic hernia, mortality has now decreased from 50 to 14%, although morbidity has increased with associated long-term pulmonary sequelae.
Single photon emission tomography (SPECT) is a well-established non-invasive technique for quantitative assessment of the regional ventilation (V) and perfusion (Q) distribution in children and in adults. We have recently developed the SPECT method for infants and neonates using a passive Technegas administration procedure. It gives a more precise and functionally oriented picture of children with chronic lung disease. In the present study, lung SPECT was applied to 12 infants under 1 year of age with congenital diaphragmatic hernia. From the SPECT results the patients were classified based on the percentage of total lung volume with a V/Q within 0.6–1.4. Lung function was deemed to be good at V/Qs >0.5, moderate if 0.3–0.5 and poor <0.3.
These results show that lung SPECT offers good sensitivity and selectivity to stage lung function in infants with CDH. Hence SPECT should be included as a part of follow-up in CDH survivors