Radiological Evaluation of Neonatal Lung Pathologies

BACKGROUND: A wide spectrum of disorders may affect the lung of neonate. Although ultrasound, CT and MRI may play a role in the diagnosis and characterization of some neonatal lung disorders, chest radiographs are primarily imaging modality used in most cases. Interpretation of neonatal chest radiographs can be challenging, because many diseases produce similar imaging findings. However, by using a systematic pattern based approach described here, one can narrow the differential diagnosis and provide essential information critical to clinical decision making. MATERIALS AND METHODS: This study included 38 newborns who were admitted in the special care baby unit in Dhiraj General hospital. Antero-posterior chest xray in supine position of neonates (pre-term, term and post-dated) were examined. Chest X � rays were taken by a portable X � ray machine using (100 cm) focus field distance, (45 � 50 kVp) and (4 � 5 mAs). Final diagnosis was based on clinical, radiological and laboratory findings. RESULT: In preterm (28-32 weeks), 21 % of neonates had pulmonary pathologies in which respiratory distress syndrome (62.5 %) was most common. In preterm (32-36 weeks), 39.50 % neonates had pulmonary pathologies in which transient tachypnoea of newborn (46.67 %) was most common followed by pneumonia (26.67 %). In neonates greater than36weeks and post-dated neonates, 39.50 % had pulmonary pathologies in which transient tachypnoea of new-born (26.67 %) was common followed by meconium aspiration syndrome (20 %) and congenital diaphragmatic hernia (13.33 %). Over all transient tachypnea of newborn (28.94 %) was most common followed by respiratory distress syndrome (21.05 %), pneumonia (15.79 %) and meconium aspiration syndrome (7.9 %), primary pulmonary hypertension (5.26 %), congenital diaphragmatic hernia (5.26 %), congenital heart disease (5.26 %) and others ( 10.52 %). CONCLUSION: Chest xray is essential in neonates with acute respiratory distress to exclude structural abnormalities such as congenital diaphragmatic hernia or congenital lobar emphysema. Any sign of post�natal respiratory distress is an indication for chest xray which should be taken as early as possible.