A clinical guideline for structured assessment of CT-imaging in congenital lung abnormalities. (March 2021)

• Record Type: Journal Article
• Authors: Hermelijn, Sergei M.; Elders, Bernadette B.L.J.; Ciet, Pierluigi; Wijnen, René M.H.; Tiddens, Harm A.W.M.; Schnater, J. Marco
• Is Part Of: Paediatric respiratory reviews. Volume 37(2021)
• Page Start: 80
• Page End: 88
• Publication Date: 2021-03
• Subjects: CLA congenital lung abnormalities -- CPAM congenital pulmonary airway malformation -- BPS bronchopulmonary sequestration -- CLE congenital lobar emphysema -- BC bronchogenic cyst -- CT computed tomography -- ILS intralobar sequestration -- ELS extralobar sequestration -- PPB pleuropulmonary blastoma; Congenital lung disease -- Computerized tomography scan -- Lung malformation -- Pediatric pulmonology -- Lung surgery; Pediatric respiratory diseases -- Periodicals; Respiratory organs -- Diseases -- Periodicals; Respiratory Tract Diseases -- Periodicals; Respiratory Therapy -- Periodicals; Child -- Periodicals; Appareil respiratoire -- Infections, chez l'enfant -- Périodiques; Appareil respiratoire -- Maladies, chez l'enfant -- Périodiques; 618.922
• DOI: 10.1016/j.prrv.2019.12.004
• Languages: English
• ISSNs: 1526-0542

Abstract

Abstract: Objectives: To develop a clinical guideline for structured assessment and uniform reporting of congenital lung abnormalities (CLA) on Computed Tomography (CT)-scans. Materials and Methods: A systematic literature search was conducted for articles describing CT-scan abnormalities of congenital pulmonary airway malformation (CPAM), bronchopulmonary sequestration (BPS), congenital lobar emphysema (CLE) and bronchogenic cyst (BC). A structured report using objective features of CLA was developed after consensus between a pediatric pulmonologist, radiologist and surgeon. Results: Of 1581 articles identified, 158 remained after title-abstract screening by two independent reviewers. After assessing full-texts, we included 28 retrospective cohort-studies. Air-containing cysts and soft tissue masses are described in both CPAM and BPS while anomalous arterial blood supply is only found in BPS. Perilesional low-attenuation areas, atelectasis and mediastinal shift may be found in all aforementioned abnormalities and can also be seen in CLE as a cause of a hyperinflated lobe. We have developed a structured report, subdivided into five sections: Location & Extent, Airway, Lesion, Vascularization and Surrounding tissue. Conclusions: CT-imaging findings in CLA are broad and nomenclature is variable. Overlap is seen between and within abnormalities, possibly due to definitions often being based on pathological findings, which is an unsuitable approach for CT imaging. We propose a structured assessment of CLA using objective radiological features and uniform nomenclature to improve reporting.