Imaging in bronchopulmonary sequestration

Abstract

SummaryBronchopulmonary sequestration is an uncommon pulmonary disorder characterized by an area of non-functioning abnormal lung tissue, which receives its blood supply from a systemic artery and characteristically has no connection with the tracheobronchial tree. The abnormal lung tissue is located within the visceral pleura of a pulmonary lobe in the intralobar variety, whereas the extralobar form has its own visceral pleura. The venous drainage of the extralobar type is usually into the systemic veins, whereas the intralobar type drains into the pulmonary veins. Radiological imaging plays a vital role in establishing the diagnosis, and even more importantly, in providing to the clinician a vascular roadmap essential for surgical planning. We present here a review of bronchopulmonary sequestration and also discuss the role of various imaging methods in the early diagnosis and management of these cases.

Tumor carcinoide e sequestro pulmonar

“…(10) The recurrent episodes of infection cause fibrosis and visceral pleural thickening. The lung parenchyma shows areas of consolidation and fibrosis containing multiple cystic formations, which can be mistaken for bronchiectasis, (5) as in the case reported here. In general, an ELPS is located in the posterior costodiaphragmatic recess, between the lower lobe and the left hemidiaphragm.…”

“…An ELPS is typically irrigated by an artery originating directly from the aorta, and, in 80% of cases, venous drainage is systemic, occurring via the azygos-hemiazygos system or via the superior vena cava, which creates a left-toright shunt. (2,5) Unlike in cases of ILPS, clinical manifestations appear in the first six months of life in cases of ELPS. Neonatal asphyxia, dyspnea, and venous contrast has allowed definitive diagnosis because of its enhanced capacity to depict communication between the anomalous artery and the PS.…”

“…An intralobar PS (ILPS) share the pleural covering with the rest of the lung, whereas an extralobar PS (ELPS) is completely covered by its own visceral pleura. (5) Although the extralobar form is well defined as a congenital abnormality, the intralobar form has a controversial pathogenesis, with some evidence indicating that, in many cases, it is an acquired disease. (6,7) Accounting for approximately 75% of all cases of PS, ILPS is more common in the lower lobes and on the left, involving the posterior basal segment.…”

“…(6,7) Accounting for approximately 75% of all cases of PS, ILPS is more common in the lower lobes and on the left, involving the posterior basal segment. (5,8) Its arterial supply is nearly always derived from the aorta or from one of its branches, typically one of a large diameter. Venous drainage is via the pulmonary veins into the left atrium, creating a left-to-left shunt.…”

Extralobar Pulmonary Sequestration in a 55-Year-Old Man

“…4) Conventionally, digital subtraction angiography (DSA) was considered the gold standard for diagnosis of pulmonary sequestration, however, it was difficult to perform in a wide range because of disadvantages such as invasive, higher cost etc. 8) Now 3D CTA plays a decisive role in the diagnosis of pulmonary sequestration, from which can be provided a more accurate spatial resolution in depicting the vessel anatomies, such as origin, shape and branch of vessels, which contributes to surgery. For those lung diseases that are difficult to diagnose, 3D CTA should be carried out timely for early detection, early diagnosis and early treatment.…”