Going With the Flow: An Aid in Detecting and Differentiating Bronchopulmonary Sequestrations and Hybrid Lesions

Oliver, Edward R.; DeBari, Suzanne E.; Giannone, Mariann M.; Pogoriler, Jennifer; Johnson, Ann; Horii, Steven C.; Gebb, Juliana; Howell, Lori J.; Adzick, N. Scott; Coleman, Beverly G.

doi:10.1002/jum.14346

Cited by 11 publications

(5 citation statements)

References 22 publications

(84 reference statements)

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“…Although we successfully identified all CPAM/BPS hybrid lesions by ultrasound, our data showed an overall low sensitivity of fetal ultrasound for finding systemic feeding vessels (49%), a result that is consistent with some but not all studies 19 30. It is possible that the earlier gestational age at ultrasound and relatively smaller size of fetal ultrasound-imaged lesions could have underestimated its relative diagnostic accuracy.…”

Section: Discussionsupporting

confidence: 76%

Diagnostic accuracy of imaging studies in congenital lung malformations

Mon

Johnson

Ladino-Torres

et al. 2018

Arch Dis Child Fetal Neonatal Ed

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Fetal ultrasound remains an important tool in the detection and evaluation of congenital lung malformations. However, it does not correctly predict histology in approximately 25% of prenatally detected CLMs and remains limited by relatively poor sensitivity for systemic feeding vessels pathognomic for a bronchopulmonary sequestration. These data suggest the importance of obtaining additional cross-sectional imaging, preferably a postnatal CT scan, in all patients to help counsel families and to guide in the optimal management of these lesions.

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Section: Discussionsupporting

confidence: 76%

Diagnostic accuracy of imaging studies in congenital lung malformations

Mon

Johnson

Ladino-Torres

et al. 2018

Arch Dis Child Fetal Neonatal Ed

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“…Since the pleura cannot be visualized at prenatal imaging, other findings help to distinguish them, with ELS usually demonstrating venous draining via the systemic system and being nonaerated on postnatal CT, and ILS generally demonstrating pulmonary venous return and being often aerated on postnatal imaging . Prenatally, US can best visualize venous return . Sometimes ELS may present surrounded by pleural fluid (Figure ).…”

Section: Introductionmentioning

confidence: 99%

“…The natural history of sequestration is similar to that of CPAM. In a recent review of sequestrations seen prenatally, the authors showed a decrease in size of the lesions after the 26 to 28 week of gestation, with the lesions rarely necessitating prenatal intervention . Of the 103 cases included, 4% developed hydrops which resolved prenatally after the mothers received betamethasone and/or placement of thoracoamniotic shunt or thoracentesis.…”

Section: Introductionmentioning

confidence: 99%

Imaging of fetal tumors and other dysplastic lesions: A review with emphasis on MR imaging

et al. 2020

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Fetal tumors and other dysplastic masses are relatively rare. They are usually the result of failure of differentiation and maturation during embryonic or fetal life; dysplastic lesions may be the consequence of an obstruction sequence. In this review, we present the most commonly encountered tumors and masses seen during fetal life. Imaging characteristics, tumoral organ of origin, and its effect on the surrounding organs and overall fetal hemodynamics are descriptors that must be relayed to the fetal surgeon and maternal fetal medicine expert, in order to institute most accurate parental counseling and appropriate perinatal treatment plan.

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“…6,8 A hybrid lesion is either an ILS or an ELS which shows the characteristics of both a BPS and a congenital pulmonary airway malformation (CPAM), another type of CLA in which overgrowth of respiratory tract tissue leads to the formation of cysts. 6,10,11 BPS can be diagnosed prenatally by routine ultrasonography, when it resembles a hyper echogenic solid mass, commonly appearing like a wedge. 12,13 Doppler ultrasound is frequently used to identify the systemic feeding artery, which is pathognomonic for a BPS.…”

Section: Introductionmentioning

confidence: 99%

The Diagnostics and Management of Bronchopulmonary Sequestration: An International Survey among Specialized Caregivers

Kersten,

Jansen,

Zuidweg

et al. 2024

Eur J Pediatr Surg

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Background Our objective was to explore the treatment preferences for bronchopulmonary sequestration (BPS) among an international group of specialized caregivers. Methods Sixty-three participants from 17 countries completed an online survey concerning the diagnostics, treatment, and follow-up. Recruitment took place among members of the Collaborative Neonatal Network for the first European Congenital Pulmonary Airway Malformation Trial Consortium and through the Association for European Pediatric and Congenital Cardiology working group database. Results Most of the 63 participants were pediatric surgeons (52%), followed by pediatric pulmonologists (22%), and pediatric cardiologists (19%). The majority (65%) treated more than five cases per year and 52% standardly discussed treatment in a multidisciplinary team. Half of the participants (52%) based the management on the presence of symptoms, versus 32% on the intralobar or extralobar lesion localization. Centers with both surgical and interventional cardiac/radiological facilities (85%) preferred resection to embolization in symptomatic cases (62 vs. 15%). In asymptomatic cases too, resection was preferred over embolization (38 vs. 9%); 32% preferred noninterventional treatment, while 11% varied in preference. These treatment preferences were significantly different between surgeons and nonsurgeons (p < 0.05). Little agreement was observed in the preferred timing of intervention as also for the duration of follow-up. Conclusions This survey demonstrates a variation in management strategies of BPS, reflecting different specialist expertise. Most centers treat only a handful of cases per year and follow-up is not standardized. Therefore, management discussion within a multidisciplinary team is recommended. Recording patient data in an international registry for the comparison of management strategies and outcomes could support the development of future guidelines. Level of Evidence: Level IV.

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Going With the Flow: An Aid in Detecting and Differentiating Bronchopulmonary Sequestrations and Hybrid Lesions

Abstract: Ultrasound is most accurate for systemic feeding artery detection in bronchopulmonary sequestrations and hybrid lesions and can also type the lesions as intralobar or extralobar when draining veins are evaluated.

Cited by 11 publications

References 22 publications

Diagnostic accuracy of imaging studies in congenital lung malformations

Diagnostic accuracy of imaging studies in congenital lung malformations

Imaging of fetal tumors and other dysplastic lesions: A review with emphasis on MR imaging

The Diagnostics and Management of Bronchopulmonary Sequestration: An International Survey among Specialized Caregivers

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