Ultrasound detected prenatal hyperechoic lung lesions and concordance with postnatal findings: A common aspect for multiple diagnoses

Abstract

Objective Hyperechoic lung lesions are largely detected prenatally but their underlying etiology is still poorly defined. The aim of the study was to determine the concordance between pre and postnatal diagnosis of hyperechoic lung lesions. Methods Prenatal ultrasound (US) evaluation was performed by a fetal medicine specialist. Postnatal diagnosis was based on CT‐scan. Pre‐ and postnatal features were retrieved from medical charts. Results Seventy five patients were included from January 2009 to December 2018. Main prenatal diagnoses were bronchopulmonary sequestrations (BPS) (n = 24%‐32%), pulmonary cystic malformations (PCM) (n = 19%‐25%), congenital lobar emphysemas (CLE) (n = 15%‐20%). Mediastinal shift was observed in 18 cases (24%). The prenatal detection of a systemic arterial supply had a diagnostic accuracy of 90%, while the prenatal detection of a cystic component had a diagnostic accuracy of 76.5%. All 16 neonates with prenatal isolated mediastinal shift were asymptomatic at birth. Seven neonates showed respiratory distress that was not predicted prenatally. Conclusions Hyperechoic lung malformations reflect a heterogeneous group of lesions with a good concordance for bronchopulmonary sequestration, but not a satisfying prediction for cystic lesions.

Echogenic lung: use of high‐frequency ultrasound and color Doppler to diagnose congenital peripheral bronchial obstruction

“…previously described in congenital lobar overinflation on MRI 1,6 . Moreover, bronchiectasis may be located distally in a pulmonary lobe and could therefore be overlooked.…”

“…Echogenic lung results from fluid retention in the bronchial tree and pulmonary alveoli, with an increase in volume of the downstream segment. Bronchiectasis can be visualized at the hilum in cases of proximal atresia (obstruction of a stem bronchus) as previously described in congenital lobar overinflation on MRI 1,6 . Moreover, bronchiectasis may be located distally in a pulmonary lobe and could therefore be overlooked.…”

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

“…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 ].…”