Prenatal diagnosis of fetal intraabdominal extralobar pulmonary sequestration: a 12-year 3-center experience in China

Xu, Ganqiong; Zhou, Jiawei; Zeng, Shi; Zhang, Ming; Ouyang, Zhu; Zhao, Yili; Huang, Yuan; Tong, Lili; Yin, Chan; Zhou, Qing

doi:10.1038/s41598-018-37268-1

Cited by 9 publications

(6 citation statements)

References 32 publications

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“…We report several prenatal ultrasound and MRI findings that were significantly associated with the diagnosis of a pulmonary sequestration in comparison to adrenal hemorrhage, which were the most common assigned diagnoses in our suprarenal lesions. In contrast to adrenal hemorrhages, pulmonary sequestrations were uniformly left-sided in this series, which is consistent with prior studies reporting a high frequency of left-sidedness [5,15]. Moreover, pulmonary sequestrations were more likely to be diagnosed earlier in gestation and have specific imaging features including a feeding vessel, solid composition with an echogenic appearance on ultrasound, and low T1 MRI signal.…”

Section: Discussion/conclusionsupporting

confidence: 89%

Prenatal Imaging Diagnosis of Suprarenal Lesions

et al. 2021

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Introduction: Prenatal suprarenal lesions represent diverse pathologies. This study investigated prenatal imaging features and regression patterns associated with specific lesion diagnoses. Methods: This is a multicenter retrospective review of fetuses with prenatally diagnosed suprarenal lesions between 2001 and 2019. Prenatal ultrasound and MRI characteristics, postnatal imaging, and clinical course were reviewed. Prenatal imaging findings were compared by the most common diagnoses and regression patterns. Results: Forty-four fetuses were prenatally diagnosed with suprarenal lesions. Diagnoses included pulmonary sequestration (n = 12; 27.3%), adrenal hemorrhage (n = 12; 27.3%), upper quadrant cyst (including 2 duplication cysts, 1 splenic cyst, and 3 indeterminate cysts), neuroblastoma (n = 4), adrenal hyperplasia (n = 3), bilateral adrenal calcifications (n = 1), and indeterminate lesions (n = 6). Sequestrations were uniformly left-sided (100 vs. 50%; p = 0.014) and diagnosed earlier in gestation than adrenal hemorrhages (p = 0.025). Sequestrations were also significantly more likely to have a prenatal feeding vessel (p = 0.005), low T1 MRI signal (p = 0.015), and no MRI blood products (p = 0.018) compared to adrenal hemorrhages. When comparing all 44 patients, a prenatal feeding vessel and low T1 signal on prenatal MRI were significantly associated with lesion persistence (p = 0.003; p = 0.044). Discussion/Conclusion: Imaging findings on prenatal ultrasound and MRI aid in the diagnosis of suprarenal lesions, including differentiating pulmonary sequestrations and adrenal hemorrhages.

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Section: Discussion/conclusionsupporting

confidence: 89%

Prenatal Imaging Diagnosis of Suprarenal Lesions

et al. 2021

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“…Additionally, according to our study, drainage veins may be associated with this anomaly. To date, the feeding artery is assessed to diagnose EPS; thus, there are few reports on assessing drainage veins for diagnosis 9,10,20,21 . Moreover, ultrasound was unable to visualize the drainage vein; however, CT was useful for the evaluation of vascular anomalies.…”

Section: Discussionmentioning

confidence: 99%

Imaging Diagnosis for Intradiaphragmatic Pulmonary Sequestration

Hosokawa,

Tanami,

Sato

et al. 2024

J of Ultrasound Medicine

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ObjectivesExtrapulmonary sequestration (EPS) within the diaphragm (ID‐EPS) is rare and requires additional procedures such as incision or detachment of the diaphragm from the lesion for diagnosis. This study aimed to describe the imaging findings and evaluate the diagnostic accuracy of ultrasonography and computed tomography (CT) for ID‐EPS.Material and MethodsSplit diaphragm sign, shape of lesion edge, drainage vein into intra‐abdomen on ultrasound and CT, and lesion characteristics on ultrasound were compared between patients with ID‐EPS and with above‐diaphragm EPS (AD‐EPS) using Fisher's exact test.ResultsThree and nine patients were diagnosed with ID‐EPS and AD‐EPS, respectively. Significant differences were observed between the two groups in the split diaphragm sign on ultrasound (presence/absence in patients with ID‐EPS vs AD‐EPS, 2/1 vs 0/9, P = .046), shape of lesion edge on ultrasound/CT (round/beak in patients with ID‐EPS vs AD‐EPS, 3/0 vs 0/9, P = .005 on both CT and ultrasound), lesion characteristics on ultrasound (presence/absence of cystic area within lesion in patients with ID‐EPS vs AD‐EPS, 0/3 vs 7/2, P = .046), and the drainage vein into the abdomen on CT (presence/absence in patients with ID‐EPS vs AD‐EPS; 2/1 vs 0/9, P = .046). No drainage veins were visualized in the abdomen on ultrasonography and no significant differences in the presence/absence of the split‐diagram sign on CT (presence/absence in patients with ID‐EPS vs AD‐EPS and ID‐EPS; 0/3 vs 0/9, P > .999; 1/2 vs 0/9, P = .250) were observed between the two groups.ConclusionA combination of postnatal ultrasonography and CT was useful in predicting EPS located within the diaphragm.

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“…As most PS cases remain asymptomatic after birth, intrusive pathological diagnosis can hardly be obtained in a large surveillance system like CBDMN. Some comparative studies have revealed a high concordance (> 90%) between prenatal ultrasound diagnosis and postoperative pathological confirmation [ 4 , 45 ]. For the past 30 years, sonographic technology has been widely used in China for the prenatal and postnatal detection of structural malformations, including PS [ 23 , 46 ].…”

Section: Discussionmentioning

confidence: 99%

“…The most widely accepted theory is that PS results from the formation of an accessory lung bud below the normal lung buds [2]. It may occur as an isolated lesion or in association with other malformations [2][3][4]. Clinically, PS cases are usually divided into the intralobar and extralobar types.…”

Section: Introductionmentioning

confidence: 99%

Epidemiology and prevalence of pulmonary sequestration in Chinese population, 2010–2019

Gao

et al. 2023

BMC Pulm Med

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Background Pulmonary sequestration (PS) is the second common congenital lung malformation and has been known for over 150 years. However, there is a scarcity of epidemiological studies on it. This study aimed to characterize the epidemiology of pulmonary sequestration in Chinese population in the recent decade by using a nationwide database. Methods Using data from the Chinese Birth Defects Monitoring Network during 2010–2019, the prevalence rates for PS were calculated by birth year, maternal age, residence area, geographical region, and infant sex. Variations in prevalence and changes over time were further examined. Other variables of interest for analysis included the pregnancy outcomes of affected infants, the prenatal diagnosis, and the co-occurring anomalies of PS cases. Results During the study period, we identified an average prevalence rate of 0.31, 0.11, and 0.42 per 10,000 live and still births for the isolated, non-isolated, and overall PS, respectively. An upward trend was observed for each category of PS. The prevalence rates varied significantly by maternal age (< 20 years, 0.34/10,000; 20–24 years, 0.33/10,000; 25–29 years, 0.45/10,000; 30–34 years, 0.46/10,000; ≥ 35 years, 0.36/10,000), residence area (urban vs. rural, 0.51/10,000 vs. 0.30/10,000), geographical region (western, 0.33/10,000; eastern, 0.49/10,000; central, 0.43/10,000), and by infant sex (male vs. female, 0.45/10,000 vs. 0.38/10,000). Non-isolated PS cases were more likely born prematurely than isolated cases (15.29% vs. 7.83%). 40.28% and 33.80% of non-isolated cases were accompanied by additional respiratory, and circulatory system malformations, respectively. Conclusions The study presents for the first time the prevalence of pulmonary sequestration in Chinese population. The rising prevalence and relatively poor perinatal outcome of affected fetuses or newborns indicate the necessity to improve perinatal management of PS.

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Prenatal diagnosis of fetal intraabdominal extralobar pulmonary sequestration: a 12-year 3-center experience in China

Cited by 9 publications

References 32 publications

Prenatal Imaging Diagnosis of Suprarenal Lesions

Prenatal Imaging Diagnosis of Suprarenal Lesions

Imaging Diagnosis for Intradiaphragmatic Pulmonary Sequestration

Epidemiology and prevalence of pulmonary sequestration in Chinese population, 2010–2019

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