Congenital lung masses (CLM) the rare group of causes of acute respiratory insufficiency (RI) in newborns include congenital airway pulmonary malformation (CAPM), congenital overinflation, bronchopulmonary sequestration, and bronchial atresia. The presenting group consists of 13 newborns who were admitted to the Neonatal Department of Intensive Medicine (NDIM) during January 1st 2015-December 31st 2019 (8 males, 5 females, 2 premature/11 term newborns, spontaneous delivery: 2, caesarean section: 11) with positive prenatal diagnosis of CAPM in all cases. In 2 cases prenatal intervention was performed (drainage of the amniotic fluid, attempt of thoracentesis). Signs of acute RI immediately after delivery were seen in 5 newborns. Postnatal echocardiographic investigation confirmed the presence of increased pulmonary pressure in 8 patients, no patient had congenital heart abnormality. A thorax x-ray was positive also in asymptomatic patients. Computed tomography in patients brought detailed information about the position, size and character of CAPM. Six patients underwent surgery. In 15.4 % right lungs were affected by cystic malformation and in 23 % left lungs were affected. A final diagnosis of CAPM was confirmed in 5 patients using histopathologic examination. Multidisciplinary cooperation during prenatal as well as postnatal period is necessary.
- MeSH
- cystická adenomatoidní malformace plic vrozená komplikace diagnostické zobrazování patofyziologie chirurgie MeSH
- lidé MeSH
- novorozenec MeSH
- plíce abnormality diagnostické zobrazování patofyziologie chirurgie MeSH
- pneumektomie MeSH
- počítačová rentgenová tomografie MeSH
- respirační insuficience diagnostické zobrazování etiologie patofyziologie chirurgie MeSH
- retrospektivní studie MeSH
- rizikové faktory MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- novorozenec MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
INTRODUCTION: Lung agenesis is a rare disorder with a variable, but potentially very bad clinical course. It necessitates complex clinical management, especially in life-threatening situations. CASE REPORT: We describe a case of a 6-month-old girl with right lung agenesis who required venovenous extracorporeal membrane oxygenation (VV-ECMO) due to pneumonia complicated by exacerbated previously diagnosed left main bronchus stenosis. The stenosis was resolved by endobronchial intervention and X-ray-guided stent insertion, which enabled weaning from ECMO and was aimed at preventing such a life-threatening respiratory failure in the future. Unfortunately, even with the functional stent, the baby died 2 months post-procedure due to unresolvable bronchial spasms. DISCUSSION: Despite high endobronchial stenting-related mortality in children, in cases where no effective pharmacological or surgical alternatives exist, stenting may be safely performed during VV-ECMO support and be a viable option to overcome critical respiratory failure caused by bronchial stenosis.
- Klíčová slova
- airway stent, lung agenesis, paediatric VV-ECMO,
- MeSH
- bronchy abnormality MeSH
- kojenec MeSH
- lidé MeSH
- mimotělní membránová oxygenace metody MeSH
- mnohočetné abnormality chirurgie MeSH
- plíce abnormality chirurgie MeSH
- plicní nemoci chirurgie MeSH
- respirační insuficience patologie chirurgie MeSH
- Check Tag
- kojenec MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- práce podpořená grantem MeSH
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.
- Klíčová slova
- bronchopulmonary malformation, computed tomography, histopathological findings, predetermined criteria,
- MeSH
- abnormality dýchací soustavy diagnostické zobrazování patologie MeSH
- kojenec MeSH
- kontrastní látky MeSH
- lidé MeSH
- plíce abnormality diagnostické zobrazování MeSH
- počítačová rentgenová tomografie normy MeSH
- předškolní dítě MeSH
- senzitivita a specificita MeSH
- Check Tag
- kojenec MeSH
- lidé MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- hodnotící studie MeSH
- srovnávací studie MeSH
- Názvy látek
- kontrastní látky MeSH
PURPOSE: The aim of our study was to assess incomplete and accessory interlobar fissures using volumetric thin-section high-resolution computed tomography (HRCT). MATERIALS AND METHODS: Retrospective assessment of HRCT examinations of 250 patients was performed. We assessed the localization, extension, and type of the incompleteness of fissures as well as the presence and localization of accessory fissures. We searched for possible correlation among the localization of interlobar fissures, the presence of incompleteness, and accessory fissures. RESULTS: On the left side, an incomplete oblique fissure was found in 24%. The discontinuity was present in the parahilar region and the area of the incompleteness was most frequently between 21% and 40%. The right oblique fissure was incomplete in 35%, mostly parahilarly, with the most frequent discontinuity below 20%. An incomplete horizontal fissure was found in 74%. Accessory fissures were identified in 16% of patients, with the same frequency on both sides. The most frequent finding was accessory horizontal fissure with 8.0% on the left side, superior accessory fissure (7.2%) and inferior accessory fissure (5.2%) on the right side. No correlation was found among the localization of interlobar fissures, the presence of incompleteness, and accessory fissures. CONCLUSION: Incomplete and accessory fissures are frequent anatomic variations of interlobar fissures.
- Klíčová slova
- Accessory, Anatomy, Computed tomography, Incomplete, Interlobar fissure, Pleura,
- MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- plíce abnormality diagnostické zobrazování MeSH
- počítačová rentgenová tomografie metody MeSH
- rentgenový obraz - interpretace počítačová metody MeSH
- reprodukovatelnost výsledků MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- senzitivita a specificita MeSH
- vylepšení rentgenového snímku metody MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- MeSH
- lidé MeSH
- mnohočetné abnormality epidemiologie patologie MeSH
- močové ústrojí abnormality MeSH
- novorozenec MeSH
- obličej abnormality MeSH
- plíce abnormality MeSH
- syndrom MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- novorozenec MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- Geografické názvy
- Československo epidemiologie MeSH
The authors evaluate the importance of pulmonary digital subtraction angiography (DSA) in anomalies of pulmonary tissue, the bronchial tree and vascular pulmonary malformations. In a group of eight patients, comprising unilateral pulmonary hypoplasia, pulmonary cysts, vascular malformations and pulmonary sequestrations, they analyze the asset of DSA and the place of this method in the diagnostic algorithm. Reduction of the invasive and risky character of the examination, lower costs, the possibility of immediate evaluation and subsequent processing of the picture and modification of the length of the record is one of the main advantages, as compared with classical angiography.
- MeSH
- arteriovenózní malformace diagnostické zobrazování MeSH
- digitální subtrakční angiografie * MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- plíce abnormality krevní zásobení diagnostické zobrazování MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- MeSH
- bronchy abnormality MeSH
- dítě MeSH
- lidé MeSH
- plíce abnormality diagnostické zobrazování chirurgie MeSH
- radiografie MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- MeSH
- cysty diagnóza patologie chirurgie MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- plíce abnormality MeSH
- plicní nemoci diagnóza patologie chirurgie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- MeSH
- lidé MeSH
- novorozenec MeSH
- plíce abnormality patologie MeSH
- Check Tag
- lidé MeSH
- novorozenec MeSH
- ženské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- kazuistiky MeSH
- MeSH
- dextrokardie diagnóza MeSH
- dospělí MeSH
- lidé MeSH
- plíce abnormality MeSH
- syndrom MeSH
- venae pulmonales abnormality MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- kazuistiky MeSH
