Purpose or Case Report: BPM’s are often identified prenatally; while some have more detailed imaging and description, many are loosely called congenital pulmonary airway malformations (CPAM). A chest radiograph is usually obtained at birth, but CT imaging is often deferred until 3-6months of age in asymptomatic babies, when surgical removal is being considered. Participation in a presurgical conference has indicated that there is poor standardization of both performance and interpretation of CT for BPM’s. High quality studies are most often hampered by poor timing of imaging, poor vascular opacification and obscuration of pathology due to atelectasis. There are four key internal feature of BPM’s that help with lesion characterization, differential diagnosis and management decisions. These include: systemic arterial supply; bronchial mucoid impaction; overinflated lung and macroscopic cysts. Reliable recognition and description of these features in all cases is essential for guiding surgical decisions since some lesions can be treated conservatively, especially those with just hyperinflation and mucoid impaction. A feature that tends to be overlooked is mucoid impaction, indicative of bronchial atresia. Cystic changes and overinflated lung may be mischaracterized. Small systemic arteries can be missed. Multiplanar reconstructions and interaction with maximum intensity projections and a 3D dataset are very helpful. This poster aims to educate by providing multiple illustrative imaging examples and a standardized report template useful for radiologists, clinicians, research and registries.
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