SavedAdd your journal

Journals / Adıyaman Üniversitesi Sağlık Bilimleri Dergisi / 2018 / Cilt: 4 Sayı: 3

Congenital Lung Lesions: Predictability of Lesion Type Based on Volume Analysis Using Fetal MRI, Prenatal Sonography and Postnatal Low-Dose Chest CT Angiography

Konjenital Akciğer Lezyonları: Fetal manyetik Rezonans Görüntüleme, Prenatal Ultrasonografi, Postnatal Düşük Doz Bilgisayarlı Tomografi Angiografi Kullanılarak Yapılan Hacim Ölçümününe Dayalı Lezyon Tipinin Öngörülmesi

Filiz Çelebi(Gayrettepe Florence Nightingale Hospital Radiology Department)0000-0003-4020-4019
Monica Epelman(Nemours Children's Hospital Radiology Department)0000-0001-7139-4447
Sabah Servaes(The Children's Hospital of Philadelphia Radiology Department)0000-0002-1456-8209
Teresa Victoria(The Children's Hospital of Philadelphia)0000-0002-5927-4220
Beverly Coleman(The Children's Hospital of Philadelphia)0000-0003-3108-5847
Jeffrey Hellinger(The Children's Hospital of Philadelphia Radiology Department)0000-0003-0899-6570
Oznur Leman Boyunaga(Gazi University Medical Faculty Radiology Department)0000-0002-5200-1588
Pages
992–1009
Publication Date
2018-12-15
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Larger studies are necessary to confirm these results.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:PURPOSE: To compare volumes and growth rates of 3 major types of congenital lung lesions (CLL) and to determine if volume measurement can improve lesion characterization.
📊
Key Findings & Data:MATERIALS AND METHODS: Retrospective analysis of 59 infants (0- 101days) with pathologically proven CLL was performed.
💡
Conclusion & Impact:Larger studies are necessary to confirm these results.
🔬Design:Araştırma Makalesi
📍Scope:Comprehensive Sample
⚙️Variables:KKAM · Konjenital akciğer lezyonları · Bronşiyal atrezi

Abstract

PURPOSE: To compare volumes and growth rates of 3 major types of congenital lung lesions (CLL) and to determine if volume measurement can improve lesion characterization. MATERIALS AND METHODS: Retrospective analysis of 59 infants (0- 101days) with pathologically proven CLL was performed. Studies included fetal MRI and prenatal sonography (US) performed the same day at +/- 24.4 weeks gestation, and postnatal CT angiography(CTA). US volumes were extracted from the US reports. Fetal MRI was performed on a 1.5T scanner. CTA studies were acquired in 64-multidetector scanner utilizing a low-dose protocol. Data was transferred to an independent workstation for analysis. Lesion and lung volumes were calculated as described elsewhere. The lesions were classified in 3 main categories: Bronchialatresia (BA), congenital cystic adenomatoid malformation (CCAM), and bronchopulmonary sequestration (BPS), although it should be noted that at least 40%of the lesions suggested more than one histologic type. Statistical analyses was performed using the analysis of variance to identify significant differences in mean lesion volume between groups, intraclass correlation, or Fisher exact tests (P <0 .05). RESULTS: Mean volumetric MR measurements were as follow: 11.6cc (95%CI 7.7-15.1) for BA, 17.6 cc (95%CI 12.6-22.6) for CCAM, and 21.6cc (95% CI 12.8-229.6) for BPS. The intraclass correlation coefficient between MRI and US measurements for the lesions was 0.94(95% CI 0.87-0.98) for BA and 0.95 (95%CI 0.87-0.95%) for CCAM. On postnatal low-dose CTA the mean volumetric measurements were: 12.1 cc (95%CI 9.3-15.2) for BA, 20.9cc (95%CI 13-28.7) for CCAM and 20.5 cc (95%CI 12.4-28.6) for BPS. CONCLUSION: There is good agreement between BA and CCAM volumes measured by MRI and those measured by US. Despite the literature quotes a peak in CCAM size occurring approximately at 25 weeks' gestation, in our series, and as measured by postnatal CTA, we encountered a very mild increase in absolute size of CCAM, with relative stable size of BA and slight decrease in volume of BPS. However, all 3 lesions demonstrated a trend toward decreasing mass volume relative to thoracic cavity volume over time. Larger studies are necessary to confirm these results.

Özet

AMAÇ: Üç ana tip konjenital akciğer lezyonunun hacim ve büyüme oranlarının karşılaştırılması, hacim ölçümünün lezyon karakterizasyonundaki etkinliğinin tanımlanması amaçlanmıştır. GEREÇ VE YÖNTEM: Çalışmamızda patolojik olarak kanıtlanmış konjenital akciğer hastalığı olan 59 infant (0-101 gün) retrospektif olarak değerlendirildi. Görüntüleme yöntemlerinden aynı günde (gestasyonun +/ - 24,4 haftasında) fetal MRG, prenatal US ve postnatal olarak da BTA uygulandı. US hacimleri prenatal ultrason raporlarından alındı. Fetal MRG 1.5 T MRG sistemi ile yapıldı. BTA ise 64-kesitli BT sistemi ile düşük doz protokolü kullanılarak gerçekleştirildi. Daha sonra çalışma istasyonlarında hacim ölçümleri gerçekleştirildi. Lezyonlar 3 ana kategoride sınıflandırıldı: Bronşiyal atrezi (BA), konjenital kistik adenomatoid malformasyon (KKAM) ve bronkopulmoner sekestrayon (BPS). Ancak lezyonların%40‘ından fazlasında birden çok histolojik tipin olduğu görüldü. Tanımlaman lezyonlar ve toplam akciğer hacimleri MRG ve BT görüntülerinden bilgisayar yazılımları kullanılarak hesaplandı. İstatiksel ölçüm; gruplar arası ve sınıfiçi ortalama lezyon hacmindeki anlamlı farklılık degişkenlik analizi, sınıf içi korelasyon ve Fisher Testi kullanılarak yapıldı (p<0.05). BULGULAR: MRG görüntülerinden elde olunan hacim ölçümleri şu şekildedir. BA için 11.6cc (95%CI 7.7-15.1), KKAM için 17.6 cc (95%CI 12.6-22.6) ve BPS için 21.1cc (95% CI 12.8-29.6). Prenatal US hacimleri sırasıyla BA için 9.6cc ( 95%CI6.6-12.7) , KKAM için 18.1cc (95%CI 13.3- 22.9) ve BPS için 16.1cc (95%CI 10.5-25.2). Lezyonların MRG ve US volümleri arasındaki sınıf içi korelasyon katsayısı BA için 0.94 (% 95 CI 0.87-0.98) ve KKAM için 0.95 (% 95 CI 0.87-0.95) olarak tespit edildi. BTA ile; BA için 12.1cc (%95 CI 9.3-15.2), KKAM için 20.8cc (%95 CI 13.0- 28.7), BPS için 20.5cc (%95 CI 12.3-28.6) hacim hesaplandı. SONUÇ: Sonuç olarak çalışmamızdaki bulgular değerlendirildiğinde; MRG ve US ile ölçülen BA ve KKAM hacimleri arasında güçlü bir uyum olduğu görüldü. Literatürde yaklaşık 25. gestasyon haftasında KKAM ‘da pik boyut artışı olduğu bildirilmesine rağmen bizim olgu grubumuzda; prenatal dönemde US ve MRG ile ve postnatal olarak da BTA’da görüldüğü gibi, KKAM’nun salt boyutunda ılımlı artış, BA hacminde göreceli olarak stabil seyir ve BPS hacminde az miktarda düşme olduğu görüldü. Ancak, üç ana tip lezyon hacminde de zaman içerisinde göğüs boşluğu hacminin genişlemesine göreceli olarak azalma olduğu saptandı.

🔖

Cite This Article

Çelebi, F., Epelman, M., Servaes, S., Victoria, T., Coleman, B., Hellinger, J., Boyunaga, O. L. (2018). Congenital Lung Lesions: Predictability of Lesion Type Based on Volume Analysis Using Fetal MRI, Prenatal Sonography and Postnatal Low-Dose Chest CT Angiography. Adıyaman Üniversitesi Sağlık Bilimleri Dergisi, Cilt: 4 Sayı: 3, 992–1009. https://doi.org/10.30569/adiyamansaglik.452511

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (38)

  1. Newman B. Conjenital bronchopulmonary foregut malformations: concepts and contoversies. Pediatric Radiology 2006; 36: 773-791
  2. Panicek DM, Heitzman ER, Randall PA, et al. The continuum of pulmonary developmental anomalies. Radiographics 1987; 7:747-772
  3. Farrugia MK, Raza SA, Gould S, Lakhoo K. Conjenital lung lesions. Pediatr Surg Int 2008; 24:987-991
  4. Adzick NS. Management of fetal lung lesions. Clin Perinatol 2003; 30: 481-492
  5. MacSweeney F et al. An assessment of the expanded classification of conjenital cystic adenomatoid malformations and their relationship to malignant transformation. Am J Surg Pathol 2003; 27(8): 1139-1146
  6. Fraser RS, Colman N, Müller NL, Pare PD. Synopsis of diseases of the chest. 3rd ed. Philadelphia, Pa: Elsevier Saunders; 2005.
  7. Langston C. New concepts in the pathology of conjenital lung malformations. Semin Pediatr Surg 2003; 12: 17-37
  8. Imai Y, Mark EJ. Cystic adenomatoid change is common to various forms of cystic lung diseases of children. A clinicopathologic analysis of 10 cases with emphasis on tracing the bronchial tree. Arch Pathol Lab Med 2002; 126: 924-940
  9. Berrocal T, Madrid C, Novo S, et al. Conjenital anomalies of the trakeobronchial tree, lung, and mediastinum: embrology, radiology, and pathology. Radiographics 2003; 24: e17
  10. Kuhn JP. Caffey’s pediatric diagnostic imaging. 10th ed. Elsevier Mosby; 2004
  11. Lee EY, Boiselle PM, Cleveland RH. Multidetector CT evaluation of conjenital lung anomalies. Radiology 2008; 247 (3):632-647
  12. Zylak CY, Eyler WR, Spizarny DI, Stone CH. Developmental lung anomalies in the adult: radiologic patholojic correlation. Radiographics 2002(Spec Issue): 25-43
  13. Aktogu S, Yuncu G, Halilcolar H, Ermete S,Buduneli T. Bronchojenic cysts: clinicopathological presentation and treatment. Eur Respir J 1996;9: 2017-2021
  14. Williams HJ, Johnson KJ. Imagıng of conjenital cystic lesions. Pediatr Respir Rev 2002;3: 120-127
  15. Haddadin WJ, Reid R, Jindal RM. A retroperitoneal bronchojenic cyst: A rare cause of a mass in the adrenal region. J Clin Pathol 2001; 54:801-802
  16. Itoh H, Shitamura T, Kataoka H, et al. Retroperitoneal bronchojenic cyst: Report of a case and literature review. Pathol Int 1999; 49: 152-155
  17. Webb W, Higgins CB. Conjenital bronchopulmonary lesions. In: Webb WR, ed. Thoracic imaging: pulmonary and cardiovasculary radiology. Philadelphia, Pa: Lippincott Williams & Wilkins, 2005; 1-29
  18. Pham TT, Benirschke K, Eliezer M, Stocker T, Eunhee SY. Conjenital pulmonary airway malformation (conjenital cystic adenomatoid malformation) with multiple extrapulmonary anomalies: autopsy report of a fetus at 19 weeks of gestation. Pediatric and Developmental Pathology 2004; 7:661-666
  19. Tawil MI, Pilling DW. Conjenital cystic adenomatoid malformation: is there a difference between the antenatally and postnatally diagnosed cases? Pediatr Radiol 2005; 35: 79-84
  20. Stocker JT et al. Congenital cystic adenomatoid malformation of the lung. Classification and morphologic spectrum. Hum Pathol 1977; 8:155-171
  21. Usui N, Kamata S, Sawai T, et al. Outcome predictors for infants with cystic lung disease. J Pediatr Surg 2004; 39:603-606
  22. Sauvat F, Michell JI,Benachi A, Edmond S, Revillon Y. Management of asymptomatic neonatal cystic adenomatoid malformations. J Pediatr Surg 2003; 38:548-552
  23. Khosa JK, Leong SL, Borzi PA. Conjenital cystic adenomatoid malformation of the lung: indications and timing of surgery. Pediatr Surg Int 2004; 20:505-508
  24. Yıkılmaz A, Lee EY. CT imaging of masslike nonvascular pulmonary lesions in children. Pediatr Radiol 2007; 37(12):1253-1263
  25. Kitaoka H, Burri PH, Weibel ER. Development of the human fetal airway tree. Analysis of the numerical density of airway end tips. Anat Rec 1996; 244:207-213
  26. Yoshioka N, Minami M, Inoue Y, et al. Pedunculated bronchogenic cyst mimicking pleural lesion. J Comput Assist Tomogr 2000; 24:581-583
  27. Dembinski J, Kaminski M, Schild R, et al. Conjenital intrapulmonary bronchogenic cyst in the neonate: Perinatal management. Am J Perinatol 1999; 16:509-514
  28. Lee EY, Siegel MJ. MDCT of tracheobronchial narrowing in pediatric patients. J Thorac Imaging. 2007; 22:300-309
  29. Lee EY, Siegel MJ. Pediatric iırways disorders: large airways. In: Boiselle PM, Lynch DA, eds. CT of the airways. Totowa, NJ: Humana 2008; 351-380
  30. Donnely LF, Emery KH, Brody AS, et al. Minimizing radiation dose for pediatric body applications for single-detector helical CT: strategies at a large children’s hospital. AJR Am J Roentgenol 2001; 176:303-306
  31. Haaga JR. Radiation dose management weighing risk versus benefit. AJR Am J Roentgenol 2001; 177:289-291
  32. Paterson A, Frush DP, Donnelly L. Helical CT of the body: are settings adjusted for pediatric patients? AJR Am J Roentgenol 2001; 297-301
  33. Slovis TL. The ALARA concept in pediatric CT: myth or reality? Radiology 2002; 223:5-6
  34. Cody DD. AAPM/RSNA physics tutorial for residents: topics in CT-image processing in CT. Radiographics 2002; 22:1255-1268
  35. Lipson SA. Image reconstruction and review. In: Lipson SA. MDCT and 3D workstations. New York, NY: Springer Science and Business Media 2006;30-40
  36. Honda O, Johkoh T, Yamamoto S, et al. Comparison of quality of multiplanar reconstructions and direct coronal multidetector CT scans of the lung. AJR Am J Roentgenol 2002; 179: 875-879
  37. Siegel MJ. Multiplanar and three-dimensional multi-detector row CT of thoracic vessels and airways in the pediatric population. Radiology 2003; 229:641-650
  38. Lee EY, Siegel MJ, Sierra LM, Foglia RP. Evaluation of angioarchitecture of pulmonary sequestration in pediatric patie MDCT angiography. AJR Am J Roentgenol 2004; 183:183-188