Evaluation of Angioarchitecture of Pulmonary Sequestration in Pediatric Patients Using 3D MDCT Angiography

Lee, Edward Y.; Siegel, Marilyn J.; Sierra, Lina M.; Foglia, Robert P.

doi:10.2214/ajr.183.1.1830183

Cited by 80 publications

(43 citation statements)

References 14 publications

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“…This study provides the best evaluation of the vascular anatomy of the lesion and the appearance of the lesion itself, and of the diaphragm and remainder of the lung. 10 Although magnetic resonance imaging can be performed without radiation and does provide excellent vascular visualization, it does not provide the same high-quality evaluation of the pulmonary parenchymal part of the lesion. 11 In addition to the concern for recurrent infections in ILS, there is also a currently recognized risk in cystic adenomatoid malformation or congenital lung cysts for development of pleuropulmonary blastoma.…”

Section: Denouement and Discussionmentioning

confidence: 99%

Congenital intralobar pulmonary sequestration with cystic adenomatoid malformation

Herman

Siegel

2009

J Perinatol

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Case presentation A 3000 g infant was born at 39 weeks gestation to a gravida 2, para 2 mother after a pregnancy complicated by an abnormal fetal sonogram that was reported to demonstrate a large cystic thoracic mass. The baby was delivered by elective repeat C-section and had Apgar scores of 8 at 1 min and 9 at 5 min. The infant was not in distress. An initial plain chest radiograph (Figure 1), abdominalthoracic sonogram ( Figure 2) and a multidetector chest computed tomography (CT) and CT angiogram ( Figure 3) were then performed. Denouement and discussionThe chest radiograph shows subtle lucency in the left lower lobe and hyperexpanded left lung. The sonogram showed an echogenic mass with feeding artery. CT confirmed the presence of an intrapulmonary, hypervascular cystic and solid mass in the medial posterior left lower lobe. The lesion receives arterial blood supply from an anomalous vessel directly arising from the thoracic aorta and has drainage through an anomalous vein into the azygos vein. The air-filled cystic component of the lesion is peripherally located and at the interface with the more normal lung. The remainder of the lesion is not aerated, but is surrounded by normally aerated left lower lobe, medially, laterally and superiorly. Because of the risk of infection and malignant degeneration, which is associated with the presumed cystic adenomatoid elements in this lesion, the lesion was resected. Surgical resection demonstrated a cystic and solid mass in the left lower lobe with blood supply from a 1-cm diameter artery arising directly from the thoracic aorta with venous drainage into the azygos vein. This complex mass was within the left lower lobe and within the visceral pleural. Pathological examination of the specimen confirmed a sequestration and associated congenital cystic adenomatoid malformation with intermediate-type cysts between types 1 and 2.Intralobar sequestration (ILS) refers to nonfunctioning lung tissue with anomalous arterial supply from the aorta, venous

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Section: Denouement and Discussionmentioning

confidence: 99%

Congenital intralobar pulmonary sequestration with cystic adenomatoid malformation

Herman

Siegel

2009

J Perinatol

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“…The usefulness of MDCT for visualization of the aberrant artery in pulmonary sequestration has been demonstrated in infants and school-age children [2,3,7]. In the present cases, MDCT was used to visualize ultra-fine aberrant arteries (as small as 3.0 mm in diameter) in neonates weighing as little as 2900 g without deep sedation.…”

Section: Discussionmentioning

confidence: 78%

“…Diagnosis of pulmonary sequestration where the aberrant artery has been detected by contrast computed tomography (CT) [1][2][3] or magnetic resonance angiography (MRA) [1,[4][5][6] instead of by conventional angiography is becoming more common. However, the aberrant artery is difficult to visualize in neonates because of the fineness of the artery and neighboring respiratory and cardiac motion.…”

Section: Introductionmentioning

confidence: 99%

Usefulness and Limitations of Multidetector Computed Tomography Angiography for Visualization of Thoracic Aberrant Arteries in Neonates

Mitsunaga¹,

Komatsu²

2017

Clin Pediatr OA

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We describe two neonatal patients where the final diagnosis differed in whom multidetector computed tomography (MDCT) angiography could clearly visualize the intrathoracic aberrant artery. The first case was a infant with a right intrathoracic tumor detected by fetal sonography. MDCT was performed 13 days after birth at a weight of 3492 g. An aberrant arteries arising from the Th10-high aorta toward the right lower lobe was detected. A right lower lobectomy was performed in the diagnosis of pulmonary sequestration. The latter was an infant born at 28 weeks of gestation. MDCT was performed to investigate an abnormal right upper lobar shadow 92 days after birth at a weight of 2906 g. An aberrant arteries arising from the Th5-high aorta toward the right upper lobe was detected. We determined the artery considered aberrant was an inflammatory dilated bronchial artery by conventional angiography. MDCT could visualize ultra-fine aberrant arteries in neonates. However, it cannot explore the artery peripherally or evaluate the area controlled by the artery. Conventional angiography should be performed in cases without a branch defect of the bronchus or pulmonary artery, and in those cases with an aberrant artery arising from Th5-Th6-high thoracic aorta, which cannot be distinguished from the bronchial artery.

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“…It is reported that spiral CT demonstrates two thirds of the arterial supplies, and most venous drainages cannot be shown (8,9). Whereas, MDCT is capable to simultaneously demonstrate the arterial supply, venous drainage and parenchymal changes in a single examination (10,11). We were able to demonstrate arterial supply and venous drainage in all thesix patients who underwent MDCT.…”

mentioning

confidence: 70%

“…Arteriography is the method of choice to demonstrate the systemic vessels supplying the abnormal portion of the lung (4,5). Several studies mainly consisting of case reports have shown that magnetic resonance imaging (MRI), helical computed tomography (HCT) and multidetector computed tomography (MDCT) angiography may be used to demonstrate the aberrant vasculature and the bronchial anatomy (6)(7)(8)(9)(10)(11). In the study we aimed to evaluate the accuracy of MDCT in demonstrating the feeding artery and draining veins.…”

Section: Evaluation Of Diagnostic Accuracy Of Computed Tomography To mentioning

confidence: 99%

Evaluation of diagnostic accuracy of computed tomography to assess the angioarchitecture of pulmonary sequestration

Büyükoğlan

Mavili²,

Tutar³

et al. 2011

Tuberk Toraks

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Evaluation of Angioarchitecture of Pulmonary Sequestration in Pediatric Patients Using 3D MDCT Angiography

Abstract: MDCT angiography with 3D rendering shows the anomalous feeding artery and the draining veins that allow a diagnosis of pulmonary sequestration. These features may prove useful in distinguishing intra- and extralobar sequestration and in surgical planning.

Cited by 80 publications

References 14 publications

Congenital intralobar pulmonary sequestration with cystic adenomatoid malformation

Congenital intralobar pulmonary sequestration with cystic adenomatoid malformation

Usefulness and Limitations of Multidetector Computed Tomography Angiography for Visualization of Thoracic Aberrant Arteries in Neonates

Evaluation of diagnostic accuracy of computed tomography to assess the angioarchitecture of pulmonary sequestration

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