Diagnostic accuracy of imaging studies in congenital lung malformations

Mon, Rodrigo; Johnson, K. Norman; Ladino-Torres, Maria; Heider, Amer; Mychaliska, George B.; Treadwell, Marjorie C.; Kunisaki, Shaun M.

doi:10.1136/archdischild-2018-314979

Cited by 54 publications

(64 citation statements)

References 38 publications

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“…For example, only one-third of fetuses had an MRI as part of their prenatal diagnostic evaluation. The role of MRI in this setting remains controversial [31,32]. Less than half of prenatally diagnosed patients were followed by a calculated CVR despite multiple studies now demonstrating its prognostic value, both in terms of predicting hydrops risk as well as determining likelihood of respiratory distress at birth, among other outcome measures [12,[33][34][35][36].…”

Section: Accepted Manuscriptmentioning

confidence: 99%

“…terminology often used to describe different CLMs as well as the potential for hybrid lesions with more than one pathologic diagnosis [8,32,52]. Moreover, ICD codes for these lesions can sometimes be non-specific, such as in the case of bronchogenic cysts and CPAMs, which share the exact same ICD code despite the fact that they are pathologically distinct, have unique disease presentations, and require different operative procedures.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

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Development of a multi-institutional registry for children with operative congenital lung malformations

Kunisaki

Saito

Fallat

et al. 2020

Journal of Pediatric Surgery

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Introduction: The purpose of this study was to develop a multi-institutional registry to characterize the demographics, management, and outcomes of a contemporary cohort of children undergoing congenital lung malformation (CLM) resection. Methods: After central reliance IRB approval, a web-based, secure database was created to capture retrospective cohort data on pathologically-confirmed CLMs performed between 2009-2015 within a multi-institutional research collaborative. Results: Eleven children's hospitals contributed 506 patients. Among 344 prenatally diagnosed lesions, the congenital pulmonary airway malformation volume ratio was measured in 49.1%, and fetal MRI was performed in 34.3%. One hundred thirty-four (26.7%) children had respiratory symptoms at birth. Fifty-eight (11.6%) underwent neonatal resection, 322 (64.1%) had surgery at 1-12 months, and 122 (24.3%) had operations after 12 mos. The median age at resection was 6.7 months (interquartile range, 3.6-11.4). Among 230 elective lobectomies performed in asymptomatic patients, thoracoscopy was successfully utilized in 102 (44.3%), but there was substantial variation across centers. The most common lesions were congenital pulmonary airway malformation (n=234, 47.3%) and intralobar bronchopulmonary sequestration (n=106, 21.4%). Conclusion: This multicenter cohort study on operative CLMs highlights marked disease heterogeneity and substantial practice variation in preoperative evaluation and operative management. Future registry studies are planned to help establish evidencebased guidelines to optimize the care of these patients.

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Section: Accepted Manuscriptmentioning

confidence: 99%

Section: Accepted Manuscriptmentioning

confidence: 99%

Development of a multi-institutional registry for children with operative congenital lung malformations

Kunisaki

Saito

Fallat

et al. 2020

Journal of Pediatric Surgery

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“…However, with the advent of advanced fetal imaging, most of these lesions are diagnosed prenatally and patients are asymptomatic postnatally. Prenatal ultrasonography serves as a useful diagnostic modality with a high sensitivity of 81%‐93% but poor specificity of 32% for CCAM detection . Postnatally, a CT scan is considered standard of care to confirm the continued presence of the mass, further define its anatomy and determine whether there is extension into the abdomen.…”

Section: Discussionmentioning

confidence: 99%

“…Prenatal ultrasonography serves as a useful diagnostic modality with a high sensitivity of 81%-93% but poor specificity of 32% for CCAM detection. 22,23 Postnatally, a CT scan is considered standard of care to confirm the continued presence of the mass, further define its anatomy and determine whether there is extension into the abdomen. A contrast study may be considered to evaluate for communication between a duplication cyst and the esophagus, although this is rare.…”

Section: Discussionmentioning

confidence: 99%

A congenital cystic pulmonary airway malformation occurring together with both an extralobar pulmonary sequestration and an esophageal duplication cyst

Dewberry

Trecartin

Galambos

et al. 2019

Clinical Case Reports

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A foregut duplication cyst occurring together with both a congenital cystic pulmonary airway malformation and extralobar pulmonary sequestration is an unusual combination. Prenatal ultrasound, MRI, and postnatal CT are helpful for operative planning. Surgical resection is the definitive management for all three anomalies. K E Y W O R D Scystic lung disease, cystic pulmonary airway malformation, esophageal duplication cyst, extralobar pulmonary sequestration, prenatal imaging

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“…20, 21, 22, 23, 24, 25 and 26 represent examples of MR-minus pathologies with regard to the difficult representability on MRI. If fibrosis, cysts, CPAM Types I and II and emphysema are suspected, lung CT might still be indicated as first-line diagnostic test in children [28]. Although MR findings are often very discreet in such MR-minus pathology, MRI can provide helpful diagnostic information in addition to the CT [29].…”

Section: Minus-pathologies Of Lung Magnetic Resonance Imagingmentioning

confidence: 99%

The current status and further prospects for lung magnetic resonance imaging in pediatric radiology

Hirsch¹,

Sorge²,

Vogel‐Claussen

et al. 2020

Pediatr Radiol

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Lung MRI makes it possible to replace up to 90% of CT examinations with radiation-free magnetic resonance diagnostics of the lungs without suffering any diagnostic loss. The individual radiation exposure can thus be relevantly reduced. This applies in particular to children who repeatedly require sectional imaging of the lung, e.g., in tumor surveillance or in chronic lung diseases such as cystic fibrosis. In this paper we discuss various factors that favor the establishment of lung MRI in the clinical setting. Among the many sequences proposed for lung imaging, respiration-triggered T2-W turbo spin-echo (TSE) sequences have been established as a good standard for children. Additional sequences are mostly dispensable. The most important pulmonary findings are demonstrated here in the form of a detailed pictorial essay. T1-weighted gradient echo sequences with ultrashort echo time are a new option. These sequences anticipate signal loss in the lung and deliver CT-like images with high spatial resolution. When using self-gated T1-W ultrashort echo time 3-D sequences that acquire iso-voxel geometry in the submillimeter range, secondary reconstructions are possible.

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Diagnostic accuracy of imaging studies in congenital lung malformations

Cited by 54 publications

References 38 publications

Development of a multi-institutional registry for children with operative congenital lung malformations

Development of a multi-institutional registry for children with operative congenital lung malformations

A congenital cystic pulmonary airway malformation occurring together with both an extralobar pulmonary sequestration and an esophageal duplication cyst

The current status and further prospects for lung magnetic resonance imaging in pediatric radiology

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