Le poumon anténatal : de l'imagerie à l'interventionnel

Thanks to screening programs and high-resolution ultrasound equipment, lung developmental malformations are readily diagnosed. Given the variable consequences of these conditions, reliable methods are needed to predict the mortality as well as the level of morbidity associated with the diagnosed malformation. New ultrasonographic methods (improvement of 2D ultrasound machine's resolution, measurement of lung volume by 3D ultrasonography (Virtual Organ Computer-aided Analysis (VOCAL) imaging program), Volume Contrast Imaging and 3D power Doppler) improved the understanding of pathologies natural history as well as prognosis evaluation. MRI is still the reference technique but the use of 3D ultrasonography tends to generalize. Recent improvement in prognostic evaluation lead to minimally invasive in utero treatment for human fetuses with CDH. Tracheal occlusion is performed through the use of a balloon placed by foetoscopy. First results are encouraging in terms of mortality. Evaluation of induced short and long morbidity is still needed.