Multidetector CT Evaluation of Congenital Lung Anomalies

Abstract

Congenital lung anomalies vary widely in their clinical manifestation and imaging appearance. Although radiographs play a role in the incidental detection and initial imaging evaluation in patients with clinical suspicion of congenital lung anomalies, cross-sectional imaging such as computer tomography (CT) is frequently required for confirmation of diagnosis, further characterization, and preoperative evaluation in the case of surgical lesions. Recently, with the development and widespread availability of multidetector CT scanners, CT has assumed a greater role in the noninvasive evaluation of congenital lung anomalies. The combination of fast speed, high spatial resolution, and enhanced quality of multiplanar reformation and three-dimensional reconstructions makes multidetector CT an ideal noninvasive method for evaluating congenital lung anomalies. In this article, the authors review the multidetector CT technique for evaluation of congenital lung anomalies. Important clinical aspects, characteristic imaging features, and key points that allow differentiation among various anomalies are highlighted for a variety of common and uncommon conditions.

A Rare Case of Diaphragmatic Extralobar Pulmonary Sequestration

“…Usually present in the neonatal period with respiratory distress, cyanosis and or infection [2]- [12].…”

“…On CT, we can see the arterial supply through the descending aorta and the lesions may appear below the diaphragm. Reformations may be particularly useful in the detection of anomalous arterial vessels, anomalous veins and in the differentiation between intralobar and extralobar sequestration [12]. Arteriography allows to characterize well the anomalous arteries and venous drainage, valuable information in the preoperative planning [2].…”

“…Differential diagnoses include diseases such as persistent pneumonia, pulmonary congenital airway malformation (CPAM), bronchogenic and enteric duplication cyst, scimitar syndrome, and congenital diaphragmatic hernia and other less likely differential diagnoses such as neuroblastoma, and adrenal and renal lesions [12].…”

Modern imaging of the tracheo-bronchial tree

“…Recurrent pneumonia may be a presenting symptom in these patients. The classic locations for atretic bronchi are the apical and apicoposterior segments of the upper lobes [24] .…”

Congenital cystic lung disease: prenatal ultrasound and postnatal multidetector computer tomography evaluation. Correlation with surgical and pathological data

“…PS is the second most common lesion after CPAM, characterised by a portion of lung parenchyma that does not connect with the tracheobronchial system and is therefore not ventilated whereas a systemic arterial supply is always present [2]. Based on the age of onset, PS may be distinguished in intralobar and extralobar; the latter may be associated with other congenital anomalies [1,8,9]. CLE is a structural disorder linked to anomalous cartilage development of the bronchus, resulting in the overinflation of one or more pulmonary lobes.…”