{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T22:00:18Z","timestamp":1773007218897,"version":"3.50.1"},"reference-count":28,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T00:00:00Z","timestamp":1770854400000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>Neonates with congenital diaphragmatic hernia (CDH) frequently experience central airway abnormalities, including tracheobronchomalacia, which persist post\u2010surgical repair. However, these complications often remain underdiagnosed due to reliance on symptomatic evaluation and limited use of bronchoscopy. Ultrashort echo time (UTE) magnetic resonance imaging (MRI) offers a non\u2010invasive, three\u2010dimensional method to assess airway dynamics and evaluate tracheobronchomalacia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To quantify changes in central airway morphology and dynamics before and after surgical diaphragmatic repair in neonates with CDH using UTE MRI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study examined neonates with CDH admitted between 2015 and 2020 who underwent both pre\u2010 and post\u2010surgical UTE MRI. Airway dynamics were assessed using respiratory\u2010gated radial three\u2010dimensional UTE images at four breathing phases. Three\u2010dimensional airway surfaces were generated from the cricoid to the main bronchi. Changes from pre\u2010 to post\u2010surgery in cross\u2010sectional areas, dynamic collapse, and eccentricity index were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Six neonates with left\u2010sided CDH were included. Following surgery, tracheal minimum eccentricity index at end expiration decreased significantly (0.68\u2009\u00b1\u20090.06 to 0.53\u2009\u00b1\u20090.15,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.023), indicating increased collapse. The ipsilateral bronchus demonstrated similar changes, with eccentricity index decreasing significantly from 0.65\u2009\u00b1\u20090.04 to 0.55\u2009\u00b1\u20090.11 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.048), while the contralateral bronchus remained stable. Mean tracheal cross\u2010sectional area decreased from 22.7\u2009\u00b1\u20096.1\u2009mm\u00b2 to 19.1\u2009\u00b1\u20093.1\u2009mm\u00b2 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.115), while dynamic motion increased from 21\u2009\u00b1\u20097% to 40\u2009\u00b1\u200915% (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.055).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Neonates with CDH have significant central airway abnormalities pre\u2010surgery, which persists and may worsen post\u2010repair, particularly in the trachea and ipsilateral bronchus. These findings suggest tracheobronchomalacia is an underrecognized component of CDH. Integrating airway assessment into surgical planning could improve post\u2010operative outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ppul.71493","type":"journal-article","created":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T11:25:40Z","timestamp":1770895540000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Surgical Diaphragmatic Repair on Central Airway Shape in Neonatal Congenital Diaphragmatic Hernia"],"prefix":"10.1002","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2713-6533","authenticated-orcid":false,"given":"Chamindu C.","family":"Gunatilaka","sequence":"first","affiliation":[{"name":"Division of Pulmonary Medicine Cincinnati Children's Hospital Medical Center Cincinnati Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sahr","family":"Alisher","sequence":"additional","affiliation":[{"name":"College of Medicine University of Cincinnati Cincinnati Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margo","family":"Waters","sequence":"additional","affiliation":[{"name":"Department of Dermatology University of Cincinnati  Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8276-1473","authenticated-orcid":false,"given":"Qiwei","family":"Xiao","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Medicine Cincinnati Children's Hospital Medical Center Cincinnati Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-1033-2340","authenticated-orcid":false,"given":"Xavier Hoyos","family":"Cordon","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Medicine Cincinnati Children's Hospital Medical Center Cincinnati Ohio USA"},{"name":"Department of Biomedical Engineering University of Cincinnati Cincinnati Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6233-161X","authenticated-orcid":false,"given":"Nara S.","family":"Higano","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Medicine Cincinnati Children's Hospital Medical Center Cincinnati Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8080-7511","authenticated-orcid":false,"given":"Jason C.","family":"Woods","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Medicine Cincinnati Children's Hospital Medical Center Cincinnati Ohio USA"},{"name":"Department of Radiology Cincinnati Children's Hospital Medical Center Cincinnati Ohio USA"},{"name":"Department of Pediatrics University of Cincinnati Cincinnati Ohio 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