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Postnatal MRI for CDH: A pictorial review of late-presenting and recurrent diaphragmatic defects

      Highlights

      • Late-presenting or recurrent diaphragmatic defects are difficult to diagnose.
      • Radiographs alone often lead to misdiagnosis.
      • MRI can better characterize diaphragmatic discontinuity.
      • MRI acquisition techniques are discussed.
      • Select cases demonstrate imaging findings with intraoperative correlation.

      Abstract

      Late-presenting or recurrent diaphragmatic defects can pose a diagnostic challenge due to varying clinical presentations. Current diagnostic approaches include plain film radiograph for initial assessment, with other imaging modalities such as fluoroscopy, ultrasound, CT and MRI mainly utilized for troubleshooting. As a radiation-free modality, MRI can provide a more definitive diagnosis in particular cases due to its ability to visualize discontinuity of the diaphragm, distinguishing it from eventration. MRI can also accurately characterize hernia contents, defect location and size. We present our MRI technique and review cases of different hernia types with relevant discussion of the imaging findings and correlation with intraoperative findings. MRI can be a useful diagnostic tool in the assessment of late presenting or recurrent diaphragmatic hernias.

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