Prenatal diagnosis of congenital lobar fluid overload

Tsai, Pei Shan; Chen, Chih‐Ping; Lin, Dao Chen; Liu, Yu Peng

doi:10.1016/j.tjog.2017.05.001

Cited by 4 publications

(4 citation statements)

References 47 publications

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“…CLFO is also known as congenital lobar emphysema and is a rare cystic lung lesion characterized by overinfl ation of lung tissue. 25,26 Th e proposed etiological causes are bronchial cartilage hypoplasia or absence, and intrinsic or extrinsic bronchial obstruction producing a one-way valve eff ect resulting in air-trapping and progressive lobar and segmental alveolar hyperinfl ation. 10,20,25,26 Th e most common US fi nding is a solid-appearing uniformly hyperechoic lesion with absence of identifi able cyst and a systemic blood supply.…”

Section: Discussionmentioning

confidence: 99%

“…26 Prenatal MR imaging fi ndings were a homogeneous hyperintense lesion with or without mass eff ect on mediastinum and intact lung architecture with stretching or elongation of non-displaced hilar vessels. 20,25,26 Prenatal diff erential diagnosis of cystic lung lesions may not be possible based on imaging fi ndings alone. Some CCAM cases may give similar MR imaging fi ndings to CDH and CLFO, and sometimes to BPS.…”

Section: Discussionmentioning

confidence: 99%

“…25,26 Th e proposed etiological causes are bronchial cartilage hypoplasia or absence, and intrinsic or extrinsic bronchial obstruction producing a one-way valve eff ect resulting in air-trapping and progressive lobar and segmental alveolar hyperinfl ation. 10,20,25,26 Th e most common US fi nding is a solid-appearing uniformly hyperechoic lesion with absence of identifi able cyst and a systemic blood supply. 26 Prenatal MR imaging fi ndings were a homogeneous hyperintense lesion with or without mass eff ect on mediastinum and intact lung architecture with stretching or elongation of non-displaced hilar vessels.…”

Section: Discussionmentioning

confidence: 99%

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Congenital Thoracic Abnormalities: Contribution of Prenatal Magnetic Resonance İmaging to Ultrasound Diagnosis

Dinç¹,

Öztürk²

2021

Sakarya Medical Journal

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Objective We aimed to evaluate the contribution of prenatal magnetic resonance (MR) imaging to ultrasound (US) in the diagnosis of congenital thoracic abnormalities. Materials and MethodsThirty-three out of 984 pregnant women, with fetal thoracic anomalies detected at US and subsequently underwent fetal MR imaging were analyzed retrospectively. In the present methodological study, prenatal MR imaging and US findings are compared with postnatal imaging, autopsy, surgical pathologic examination, physical examination or clinical follow-up. Diagnostic sensitivities were calculated for US, MR imaging and combinations of both methods by comparing US and MR results with postnatal definite diagnoses. Results The sensitivities of US and MR imaging in detecting thoracic anomalies were 53.3% and 66.7%, respectively. Both US and MRI findings were consistent in prenatal imaging in a total 27 (82%) of cases. Both US and MR imaging made correct diagnosis in 48% of cases. MR imaging confirmed the suspected US diagnosis in 3%. Prenatal MR imaging positively contributed to US with revealing additional findings such as pulmonary hypoplasia and mediastinal shift in 30% cases. Main contribution (90%) of MR imaging to US was in congenital diaphragmatic hernia (CDH) cases. In all cases with CDH, MRI showed reduction in T2 signal consistent with pulmonary hypoplasia. MR imaging completely altered the diagnosis in 9% of cases. Total contribution rate of prenatal MR imaging to US was 42%. Sixty-seven percent of prenatally detected congenital cystic adenomatoid malformation (CCAM) and congenital lobar fluid overload (CLFO) cases exhibited spontaneous resolution before birth. Conclusion MR imaging as a complementary to US can be used successfully in the prenatal diagnosis of congenital thoracic pathologies. It can provide additional findings, confirm the suspected diagnosis or completely alter the prenatal US diagnosis. The most additional contribution of MRI to US was provided in cases of CDH. Keywords prenatal diagnosis; magnetic resonance imaging; ultrasound; thorax abnormalities Öz Amaç Çalışmada konjenital torasik anomalikleri olan fetüslerde prenatal manyetik rezonans görüntüleme (MRG)'nin prenatal ultrason (US)'na olan katkısını ortaya koymayı amaçladık. Gereç ve Yöntemler Prenatal dönemde ultrason (US) de fetal torasik anomaliler tespit edilen ve ardından fetal MRG yapılan 984 gebenin 33'ü retrospektif olarak analiz edildi. Metadolojik çalışmada, prenatal MR görüntüleme ve US bulguları doğum sonrası görüntüleme, otopsi, cerrahi patolojik inceleme, fizik muayene veya klinik takip ile karşılaştırıldı. US, MRG ve her iki yöntemin kombinasyonları için tanısal duyarlılıklar, US ve MR sonuçları, doğum sonrası kesin tanılarla karşılaştırılarak hesaplandı. Bulgular US ve MRG'nin torasik anomalileri saptamadaki duyarlılıkları sırasıyla % 53.3 ve % 66.7 bulundu. Prenatal görüntülemede olguların %82'sinde hem MR hem de US bulguları birbiriyle uyumluydu. Olguların %48'inde hem MR hem de US doğru tanıyı koydu. MRG, %3 olguda şüpheli US tanısını ...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Congenital Thoracic Abnormalities: Contribution of Prenatal Magnetic Resonance İmaging to Ultrasound Diagnosis

Dinç¹,

Öztürk²

2021

Sakarya Medical Journal

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“…External compression of vascular structures can sometimes be the cause of secondary CLE (19). Hyperechogenicity, mediastinal shift, and polyhydramnios can be observed through intrauterine ultrasonography of the lung structures, with normal blood flow (20)(21)(22)(23). During the postnatal period, the first choice for diagnosis is chest radiography (CXR), which can reveal increased aeration in the affected lobe.…”

Section: Introductionmentioning

confidence: 99%

Flexible Bronchoscopy Findings in Children with Congenital Lobar Emphysema: 8-Year Data from a Single Center Study

Tuğcu

Eryilmaz

Şa

et al. 2021

Preprint

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Introduction:Congenital lobar emphysema (CLE) is a rare developmental lung malformation that involves the hyperaeration of one or more lung lobes due to partial obstruction and occurs at a rate of 1/20,000–30,000 live births.Here,we aimed to retrospectively examine the clinical, radiological, and bronchoscopy findings of patients with CLE who were diagnosed and treated with surgical or conservative approaches in our clinic to compare our results with those in the literature. Method:We examined the clinical, and radiological data and FB findings of the patients with CLE aged 0–18 years at our center between 2013 and 2020.We also examined the symptoms and findings recorded during the patients’ follow-up. Results:.The median age of 20 patients with CLE at diagnosis was 3.2 years (range, 1 day–17 years).Respiratory distress and mediastinal shift were more prominent in the patients who underwent surgery than the patients who were followed up conservatively and diagnosed at an early age (p = 0.001, p = 0.049, p = 0.001, respectively). Discussion: In line with studies in the literature, the pulmonary symptoms and CLE-related imaging findings in our study regressed during the conservative follow-up.We recommend clinicians consider performing a detailed anamnesis for patients with unresolved respiratory symptoms and unilateral or bilateral increased ventilation,along with appropriate imaging tests and examinations, and should consider CLE in the diagnosis.

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Angeborene Lungenfehlbildungen

Mayer¹,

Gräfe²,

Hirsch³

et al. 2021

Kinder- und Jugendmedizin

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ZUSAMMENFASSUNGZu den angeborenen Lungenfehlbildungen gehören neben den häufigen kongenitalen pulmonalen Atemwegsmalformationen (CPAM), bronchopulmonale Sequester (BPS), kongenitale lobäre Emphyseme (CLE) und bronchogene Zysten. Meist liegen isolierte Befunde vor. Mehr als 75 % der Kinder werden pränatal diagnostiziert. Anhand von Lokalisation und Gefäßversorgung in der Bildgebung sowie des prä- bzw. postnatalen Verlaufs werden die Eltern beraten. Gemeinsam ist den Lungenfehlbildungen eine Begünstigung bronchopulmonaler Infekte. Auch maligne Entartungen sind beschrieben, ein Kausalzusammenhang ist bisher nicht hinreichend belegt. Selten zeigen die Kinder schwere prä- bzw. postnatale Verläufe, die einer akuten Therapie bedürfen. Ansonsten erfolgt um den 3. Lebensmonat bzw. nach Diagnosestellung eine Schnittbildgebung. Hier gewinnt das Thorax-MRT zunehmend an Bedeutung. Spontanregressionen sind selten (< 10 %). Symptomatische Läsionen werden thorakoskopisch oder offen chirurgisch entfernt. Bei asymptomatischen Läsionen müssen die Risiken rezidivierender Infektionen sowie einer malignen Entartung gegen Komplikationen einer OP abgewogen werden. Die Langzeitprognose ist bei adäquater Behandlung gut, die Lungenfunktion in der Mehrzahl der Fälle unbeeinträchtigt.

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Prenatal diagnosis of congenital lobar fluid overload

Cited by 4 publications

References 47 publications

Congenital Thoracic Abnormalities: Contribution of Prenatal Magnetic Resonance İmaging to Ultrasound Diagnosis

Congenital Thoracic Abnormalities: Contribution of Prenatal Magnetic Resonance İmaging to Ultrasound Diagnosis

Flexible Bronchoscopy Findings in Children with Congenital Lobar Emphysema: 8-Year Data from a Single Center Study

Angeborene Lungenfehlbildungen

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