Diagnosis and characterization of pulmonary sequestration using dynamic time-resolved magnetic resonance angiography

Prenatal surveillance of bronchopulmonary sequestration using 3-dimensional ultrasonography

OBJECTIVE

The purpose of this study was to assess the growth of fetal lung lesions using 3-dimensional ultrasonography (3DUS) and to note the clinical outcomes of infants with congenital bronchopulmonary sequestration (BPS) diagnosed prenatally.

METHODS

Twenty-two cases of intrathoracic BPS diagnosed prenatally occurred between May 2005 and September 2008. The volume of the BPS lesion (V(mass)) and the volume of the fetal chest (V(chest)) were measured with the 3DUS software Virtual Organ Computer-Aided Analysis (VOCAL; GE Healthcare, Kretztechnik, Zipf, Austria). The clinical outcomes of all cases were recorded.

RESULTS

Among 22 cases with fetal BPS, 8 were terminated, and 2 were lost to follow-up. The growth pattern of the BPS lesions was assessed in 12 live-born cases with 2 or 3 3DUS measurements per case. There was no statistically significant difference between the V(mass) (P = .859) and V(mass)/V(chest) (P = .078) at 19 to 24 weeks' gestational age (WGA) and greater than 24 to 30 WGA, but there was a statistically significant difference between the V(mass) (P = .010) and V(mass)/V(chest) (P = .008) at greater than 24 to 30 WGA and greater than 30 to 39 WGA. The lung lesion resolved spontaneously before birth in 4 fetuses and postnatally in 2 infants. All 12 fetuses survived to term without any prenatal intervention, were born without any evidence of neonatal respiratory impairment, and did not undergo surgical resection of the mass.

CONCLUSIONS

Our data showed that fetuses with BPS had a favorable clinical outcome, and the pulmonary mass decreased during late pregnancy and resolved spontaneously. Three-dimensional ultrasonography with VOCAL provides a useful method for assessing the growth of pulmonary lesions.