Congenital overinflation: prenatal MRI and US findings and outcomes

Abstract

Fetal MR and US demonstrate a consistent pattern of imaging findings in fetuses with CO. Many cases are asymptomatic and can be managed with nonsurgical conservative therapy. CO because of central bronchial obstruction is associated with a guarded prognosis. © 2016 John Wiley & Sons, Ltd.

Congenital Lobar Overinflation: A Rare Enigmatic Lung Lesion on Prenatal Ultrasound and Magnetic Resonance Imaging

“…The remaining 66.7% of cases in this study had findings of mucostasis within central airways or a fluid‐filled bronchus central to the hyperinflated lung on postnatal CT, raising the possibility of underlying associated bronchial atresia. The proportion of cases with fluid‐filled central bronchi was higher than the 35.2% recently reported by Johnston et al Of these cases, the most common sites of CLO in this study were the right lower lobe (37.5%) and the left upper lobe (37.5%), and the predilection for the right lower lobe was consistent with more recent studies of bronchial atresia–associated CLO …”

“…Although short, centrally located, T2‐hyperintense tubular structures suggestive of fluid‐filled bronchi were observed on MRI in 33.3% of cases in this study, these were not larger than the adjacent vessel and did not have the appearance of dilated bronchi or bronchoceles. The discrepancy between this study and that by Johnston et al may reflect differences in inclusion criteria, as only cases with pathologically proven CLO were included in our study.…”

“…Dilated central bronchi have been reported as a common finding in CLO, having been present in 68% of the cases in a series by Johnston et al, making it a critical finding for diagnosing CLO in that series. By contrast, no dilated central bronchi were identified at the time of the initial evaluation in this study.…”

“…Stretching, or elongation, of nondisplaced hilar vessels has also been described on MRI . Although macroscopic cysts are most commonly absent in prenatally detected CLO, a few case reports of pathologically proven CLO describe the presence of cysts both prenatally and postnatally . In this article, we describe CLO features not previously reported.…”

“…The most common prenatal ultrasound (US) appearance of CLO is that of a uniformly hyperechoic lung lesion relative to the normal lung with absence of identifiable cysts and a systemic arterial supply . Prenatal magnetic resonance imaging (MRI) findings parallel the US features, with the finding of a solid‐appearing lesion that is T2 hyperintense relative to the normal lung . Stretching, or elongation, of nondisplaced hilar vessels has also been described on MRI .…”