Vanishing fetal lung malformations: Prenatal sonographic characteristics and postnatal outcomes

Kunisaki, Shaun M.; Ehrenberg-Buchner, Stacey; Dillman, Jonathan R.; Smith, Ethan A.; Mychaliska, George B.; Treadwell, Marjorie C.

doi:10.1016/j.jpedsurg.2015.03.025

Cited by 67 publications

(41 citation statements)

References 31 publications

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“…The possibility of obtaining a CVR measurement decreased with increasing gestational age, with one‐third of our cohort showing evidence of partial or complete US resolution of CLLs after 32 weeks. Previous studies have documented prenatal US resolution of CLLs in as many as 50% of fetuses between 32 and 35 weeks’ gestation . The most plausible explanation for this is that some lesions become isoechoic and therefore indistinguishable from the surrounding lung parenchyma with advancing gestation.…”

Section: Discussionmentioning

confidence: 98%

“…The most plausible explanation for this is that some lesions become isoechoic and therefore indistinguishable from the surrounding lung parenchyma with advancing gestation. This is more likely to happen in microcystic lesions associated with a low CVR, with the NPV of prenatal US in the third trimester reported to be as low as 40% . Therefore, both the initial CVR, if measured before 24 weeks and the CVR measured after 32 weeks might not be the best predictors of the outcome, given expected variability in growth of CLLs throughout gestation and the relatively poor NPV of prenatal US later in gestation for detection of these lesions.…”

Section: Discussionmentioning

confidence: 99%

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Utility of Fetal Cardiac Axis and Cardiac Position Assessment in Predicting Neonatal Respiratory Morbidity in Fetal Congenital Lung Lesions

Tuzović

Copel

Stitelman

et al. 2019

J of Ultrasound Medicine

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Objectives-To assess the diagnostic performance of the fetal cardiac axis (CA) and/or cardiac position (CP) versus the congenital pulmonary malformation volume ratio (CVR) in predicting any and severe neonatal respiratory morbidity in fetal congenital lung lesions.Methods-This work was an 11-year retrospective cohort study. The sensitivity, specificity, positive predictive value, and negative predictive value of CA and/or CP assessment in prediction of respiratory morbidity were calculated before 24 weeks' gestation and between 24 and 32 weeks and compared to CVR cutoffs obtained from the literature.Results-Fifty-three patients were included. CA and/or CP abnormalities were present in 45% and 38% of patients before 24 weeks and between 24 and 32 weeks and were significantly more common in left-versus rightsided lesions (60% versus 17%; P = .003). The sensitivity, specificity, positive predictive value, and negative predictive value of an abnormal CA and/or CP for any and severe respiratory morbidity were 0.67, 0.61, 0.33, and 0.86 and 0.8, 0.58, 0.17, and 0.97 before 24 weeks and 0.75, 0.73, 0.45, and 0.91 and 0.8, 0.67, 0.20, and 0.97 between 24 and 32 weeks, respectively. An abnormal CA and/or CP had higher sensitivity for any respiratory morbidity compared to the CVR at 0.5 and 0.8 cutoffs both before 24 weeks and between 24 and 32 weeks (P < .05).Conclusions-An abnormal CA and/or CP before 24 weeks and between 24 and 32 weeks has higher sensitivity for the detection of any respiratory morbidity at birth compared to the CVR at both 0.5 and 0.8 cutoffs. A normal CA and CP have a high negative predictive value for excluding any respiratory morbidity at birth both before 24 weeks and between 24 and 32 weeks.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Utility of Fetal Cardiac Axis and Cardiac Position Assessment in Predicting Neonatal Respiratory Morbidity in Fetal Congenital Lung Lesions

Tuzović

Copel

Stitelman

et al. 2019

J of Ultrasound Medicine

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“…However, reliance on the final CVR in isolation may lead to a false negative diagnosis because some of these lesions can become isoechoic, particularly late in gestation . In all asymptomatic prenatally diagnosed cases, it remains imperative to image postnatally, preferrably by contrast‐enhanced CT scan, to further characterize any lesions if preemptive surgical resection is being considered …”

Section: Discussionmentioning

confidence: 99%

“…32 In all asymptomatic prenatally diagnosed cases, it remains imperative to image postnatally, preferrably by contrastenhanced CT scan, to further characterize any lesions if preemptive surgical resection is being considered. 33,34 Although the current series using prospectively collected data has further elucidated the prenatal growth patterns oflung malformations, the study has some caveats and limitations. This is a single institution retrospective study based on prospectively collected data with stringent inclusion criteria.…”

Section: Discussionmentioning

confidence: 99%

Surveillance of fetal lung lesions using the congenital pulmonary airway malformation volume ratio: natural history and outcomes

et al. 2016

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“…Some authors have postulated that an obstructing bronchial mucus plug may transiently induce abnormal pulmonary growth, thereby mimicking a lung malformation until the obstruction is alleviated 14 . It is also conceivable that these lesions may outgrow their existing blood supply or, as in the case of extralobar BPS, undergo spontaneous torsion towards the end of pregnancy 15 . CLO is lung segment overinflation characterized during microscopic analysis by air space enlargement without maldevelopment 5 .…”

mentioning

confidence: 99%

Congenital bronchopulmonary malformation: CT histopathological correlation

Kynčl¹,

Kočí²,

Ptackova³

et al. 2016

BIOMED PAP

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Background. This study evaluated the accuracy of postnatal computed tomography (CT) imaging in the identification of congenital bronchopulmonary malformation (BPM) in comparison with histopathological analysis. Methods. CT scans of prenatally diagnosed BPMs from 24 patients with available histology were analysed retrospectively. The CT images were reviewed blinded to histological findings by two radiologists. Specific diagnosis was assigned based on predetermined criteria. The accuracy of CT was evaluated. Results. The agreement rate in CT diagnosis between two radiologists was 100%. In 75% the lesions were located in the lower lobes. An overlap of 71% in CT and histopathological diagnoses was reached. The least matching diagnosis was type 2 CPAM. Conclusion. Contrast enhanced chest CT is very accurate in characterizing the BPM spectrum and provides important information on lesion type and structure.

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Vanishing fetal lung malformations: Prenatal sonographic characteristics and postnatal outcomes

Cited by 67 publications

References 31 publications

Utility of Fetal Cardiac Axis and Cardiac Position Assessment in Predicting Neonatal Respiratory Morbidity in Fetal Congenital Lung Lesions

Utility of Fetal Cardiac Axis and Cardiac Position Assessment in Predicting Neonatal Respiratory Morbidity in Fetal Congenital Lung Lesions

Surveillance of fetal lung lesions using the congenital pulmonary airway malformation volume ratio: natural history and outcomes

Congenital bronchopulmonary malformation: CT histopathological correlation

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