Texas Children's Fetal Center, Baylor College of Medicine, Houston, TX; Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX.
Texas Children's Fetal Center, Baylor College of Medicine, Houston, TX; Department of Radiology, Baylor College of Medicine, Houston, TX.
J Pediatr Surg. 2020 May;55(5):844-847. doi: 10.1016/j.jpedsurg.2020.01.020. Epub 2020 Jan 30.
The purpose of this study was to compare the accuracy of prenatal and postnatal imaging modalities for evaluation and management of congenital lung malformations (CLMs).
A retrospective review was performed of all fetuses evaluated for a CLM between December 2001 and January 2018. Pre and postnatal imaging findings, operative treatment, and patient outcomes were collected. Patients were included in analysis if they had fetal imaging (US and/or fetal MRI), a postnatal chest CT, and surgical pathology.
Over the study period, we identified 157 patients with prenatal imaging that also had a follow-up with postnatal chest CT at a median age of 2.1 [1.4, 3.2] months. Of these, 75% (n = 117) had surgical resection. Diagnostic accuracy (DA) for localization of unilobar lesions was 100% for pre- and postnatal imaging and 97% vs 98% for multilobar disease, respectively. On comparison for identification of aberrant vasculature and pathology prediction, pre- and postnatal imaging DAs were similar. However, postnatal CT had the highest specificity for diagnosing lesions overall (p < 0.05).
Prenatal imaging provides valuable information for counseling and possible fetal intervention. However, this study suggests that postnatal CT scan continues to provide important information for preoperative counseling and surgical management.
Retrospective study.
Level IV.
本研究旨在比较产前和产后影像学在评估和管理先天性肺畸形（CLM）中的准确性。
回顾性分析 2001 年 12 月至 2018 年 1 月期间所有评估为 CLM 的胎儿。收集产前和产后影像学表现、手术治疗和患者结局。如果患者有胎儿影像学（US 和/或胎儿 MRI）、产后胸部 CT 和手术病理学，则纳入分析。
在研究期间，我们共确定了 157 例有产前影像学检查且在中位数年龄为 2.1[1.4, 3.2]个月时有后续胸部 CT 检查的患者。其中，75%（n=117）进行了手术切除。产前和产后影像学对单叶病变定位的诊断准确性均为 100%，而多叶病变分别为 97%和 98%。在比较异常血管和病理预测的识别方面，产前和产后影像学的诊断准确性相似。然而，产后 CT 对诊断病变的特异性最高（p<0.05）。
产前影像学为咨询和可能的胎儿干预提供了有价值的信息。然而，本研究表明，产后 CT 扫描仍然为术前咨询和手术管理提供了重要信息。
回顾性研究。
IV 级。
