Association of Prenatal Congenital Lung Malformation Volume Ratio to Postnatal Computed Tomography Characteristics

• Published in: The Journal of surgical research 2024-10, Vol.302, p.755-764
• Main Authors: Montgomery, Ashley Elisabeth, Peiffer, Sarah Elizabeth, Santa Cruz, John Randall, Ketwaroo, Pamela, Lee, Timothy Chen-an, Keswani, Sundeep Govind, King, Alice
• Format: Article
• Language: English
• Subjects: Adult; CLM volume ratio (CVR); Congenital lung malformation; Female; Humans; Imaging concordance; Infant, Newborn; Lung - abnormalities; Lung - diagnostic imaging; Lung - pathology; Male; Postnatal CT scan; Pregnancy; Prenatal Diagnosis - methods; Prenatal Diagnosis - statistics & numerical data; Prenatal ultrasound; Respiratory System Abnormalities - diagnostic imaging; Respiratory System Abnormalities - pathology; Retrospective Studies; Tomography, X-Ray Computed - statistics & numerical data; Ultrasonography, Prenatal - statistics & numerical data
• ISSN: 0022-4804; 1095-8673; 1095-8673
• DOI: 10.1016/j.jss.2024.07.118

Congenital lung malformations (CLMs) are diverse and readily diagnosed on prenatal ultrasound. Postnatal computed tomography (CT) characteristics, including volume, are used in centers for the clinical decision-making of asymptomatic CLM. We aim to evaluate the relationship of prenatal CLM volume ratio (CVR) to postnatal CT characteristics by suspected prenatal diagnosis and postnatal radiological diagnosis. We performed a single-center retrospective review of all patients evaluated with prenatally diagnosed CLM (May 2015-December 2022). Demographics, prenatal imaging findings at initial evaluation, and postnatal radiological diagnosis/imaging findings were analyzed with descriptive statistics. Pairwise correlation coefficient tests were performed to analyze the correlation between prenatal CVR and postnatal CT lesion size stratified by diagnosis. Of 123 patients referred and evaluated, suspected prenatal diagnoses consisted of 68 bronchial atresia (BA), 20 intralobar bronchopulmonary sequestration (iBPS), 20 extralobar bronchopulmonary sequestration (eBPS), and nine congenital pulmonary airway malformation (CPAM). Postnatal radiological diagnoses consisted of 53 BA, 22 iBPS, 14 eBPS, and 20 CPAM. Overall correlation coefficient of prenatal CVR to postnatal CT lesion size volume was 0.56. By suspected prenatal diagnosis, correlation coefficients were 0.61 (BA), 0.59 (iBPS), 0.29 (eBPS), and 0.51 (CPAM). For postnatal radiological diagnosis, correlation coefficients were 0.58 (BA), 0.56 (iBPS), 0.33 (eBPS), and 0.62 (CPAM). Our results indicate that initial CVR is overall consistent with the postnatal CT lesion size. This correlation is present in suspected prenatal diagnoses of BA and iBPS and postnatal radiological diagnoses of BA, iBPS, and CPAM. Additional studies analyzing long-term follow-up should be conducted to specify the safety of patients who undergo observation rather than surgical intervention.