Yoon Hee Mang, Kim Ellen Ai-Rhan, Chung Sung-Hoon, Kim Seon-Ok, Jung Ah Young, Cho Young Ah, Yoon Chong Hyun, Lee Jin Seong
Department of Radiology and Research Institute of Radiology, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Korea.
Division of Neonatology, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea.
Eur Radiol. 2017 Jun;27(6):2489-2496. doi: 10.1007/s00330-016-4594-x. Epub 2016 Sep 22.
To describe the natural course of extralobar pulmonary sequestration (EPS) and identify factors associated with spontaneous regression of EPS.
We retrospectively searched for patients diagnosed with EPS on initial contrast CT scan within 1 month after birth and had a follow-up CT scan without treatment. Spontaneous regression of EPS was assessed by percentage decrease in volume (PDV) and percentage decrease in sum of the diameter of systemic feeding arteries (PDD) by comparing initial and follow-up CT scans. Clinical and CT features were analysed to determine factors associated with PDV and PDD rates.
Fifty-one neonates were included. The cumulative proportions of patients reaching PDV > 50 % and PDD > 50 % were 93.0 % and 73.3 % at 4 years, respectively. Tissue attenuation was significantly associated with PDV rate (B = -21.78, P < .001). The tissue attenuation (B = -22.62, P = .001) and diameter of the largest systemic feeding arteries (B = -48.31, P = .011) were significant factors associated with PDD rate.
The volume and diameter of systemic feeding arteries of EPS spontaneously decreased within 4 years without treatment. EPSs showing a low tissue attenuation and small diameter of the largest systemic feeding arteries on initial contrast-enhanced CT scans were likely to regress spontaneously.
• Extralobar pulmonary sequestration (EPS) could show spontaneous regression. • Initial CT features may predict spontaneous regression of EPS. • The tissue attenuation and diameter of systemic feeding artery are important factors.
描述肺叶外肺隔离症（EPS）的自然病程，并确定与EPS自发消退相关的因素。
我们回顾性检索了出生后1个月内初次行增强CT扫描诊断为EPS且未经治疗进行了随访CT扫描的患者。通过比较初次和随访CT扫描，以体积减少百分比（PDV）和体循环供血动脉直径总和减少百分比（PDD）评估EPS的自发消退情况。分析临床和CT特征以确定与PDV和PDD率相关的因素。
纳入51例新生儿。4岁时PDV>50%和PDD>50%的患者累积比例分别为93.0%和73.3%。组织衰减与PDV率显著相关（B=-21.78，P<.001）。组织衰减（B=-22.62，P=.001）和最大体循环供血动脉直径（B=-48.31，P=.011）是与PDD率相关的重要因素。
未经治疗，EPS的体循环供血动脉体积和直径在4年内自发减小。初次增强CT扫描显示组织衰减低且最大体循环供血动脉直径小的EPS可能会自发消退。
• 肺叶外肺隔离症（EPS）可自发消退。• 初始CT特征可预测EPS的自发消退。• 组织衰减和体循环供血动脉直径是重要因素。
