Showing 3 Abstracts.
Madden Joseph, Joya Sosa Yocelin, Carrico Caroline, Cao Joseph
Final Pr. ID: Poster #: CR-050
Background: Bronchopulmonary foregut malformations are defined as aberrant communications between an isolated segment of respiratory tissue and the esophagus or stomach. Based on the anatomic relationship of the fistulous connection, these rare malformations are classified into four groups (I–IV). Diagnosis typically involves a combination of cross-sectional imaging (CT or MRI) and an upper gastrointestinal series (UGI). Case: A 1-month-old infant with a history of lipomyelomeningocele was transferred from an outside hospital for neurosurgical evaluation. An incidental right lower lobe (RLL) pulmonary mass was identified on spinal MRI. Further evaluation with contrast-enhanced CT revealed a RLL lesion with a systemic arterial supply from the celiac artery. Internal cystic and branching lucencies were also present, raising concern for a hybrid lesion. The patient was discharged, and readmitted four months later for neurosurgical intervention for spinal dysraphism. The admission was complicated by intermittent oxygen desaturations, suspected to be secondary to gastroesophageal reflux. UGI revealed a communication between the lower esophagus and the isolated pulmonary segment in the right medial lung base confirming a diagnosis of group III CBPFM. Conclusions: This case highlights a hybrid lesion (sequestration and CPAM) with rare communication with the gastrointestinal tract, consistent with a communicating bronchopulmonary foregut malformation (CBPFM). Vague symptoms including recurrent pneumonia and workup for feeding intolerance often lead to delayed diagnosis. Surgical excision of CBPFMs is definitive treatment; however, identification of the communicating esophageal component is necessary prior to resection. Read More
Authors: Madden Joseph , Joya Sosa Yocelin , Carrico Caroline , Cao Joseph
Keywords: Bronchopulmonary Malformation, Bronchopulmonary Sequestration, CPAM
Emerson Miriam, Barth Richard, Rubesova Erika, Halabi Safwan, Rosenberg Jarrett, Hintz Susan, Blumenfeld Yair, Girsen Anna, Neves Stephanie, Homeyer Margaret
Final Pr. ID: Poster #: SCI-039
Congenital Pulmonary Airway Malformation Volume Ratio (CVR) is widely used during prenatal ultrasound to predict outcome of fetuses with bronchopulmonary malformations (BPM). Since fetal MRI is often performed in fetuses with BPM, the aim of our study is to correlate CVR measurements by MRI and US, to compare inter-observer agreement of CVR measured by area-based MRI volume, diameter-based volume and to assess whether large lesions would be prone to more variability in CVRs among observers. Read More
Authors: Emerson Miriam , Barth Richard , Rubesova Erika , Halabi Safwan , Rosenberg Jarrett , Hintz Susan , Blumenfeld Yair , Girsen Anna , Neves Stephanie , Homeyer Margaret
Final Pr. ID: Poster #: EDU-091
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. Read More
Authors: Newman Beverley
Keywords: standardization, bronchopulmonary malformation, computed tomography