Department of Paediatric Surgery, Erasmus University Medical Centre, Sophia Children's Hospital, Rotterdam, The Netherlands.
Department of Paediatric Pulmonology, Erasmus University Medical Centre, Sophia Children's Hospital, Rotterdam, The Netherlands; Department of Radiology, Erasmus University Medical Centre, Rotterdam, The Netherlands.
Paediatr Respir Rev. 2021 Mar;37:80-88. doi: 10.1016/j.prrv.2019.12.004. Epub 2020 Feb 20.
To develop a clinical guideline for structured assessment and uniform reporting of congenital lung abnormalities (CLA) on Computed Tomography (CT)-scans.
A systematic literature search was conducted for articles describing CT-scan abnormalities of congenital pulmonary airway malformation (CPAM), bronchopulmonary sequestration (BPS), congenital lobar emphysema (CLE) and bronchogenic cyst (BC). A structured report using objective features of CLA was developed after consensus between a pediatric pulmonologist, radiologist and surgeon.
Of 1581 articles identified, 158 remained after title-abstract screening by two independent reviewers. After assessing full-texts, we included 28 retrospective cohort-studies. Air-containing cysts and soft tissue masses are described in both CPAM and BPS while anomalous arterial blood supply is only found in BPS. Perilesional low-attenuation areas, atelectasis and mediastinal shift may be found in all aforementioned abnormalities and can also be seen in CLE as a cause of a hyperinflated lobe. We have developed a structured report, subdivided into five sections: Location & Extent, Airway, Lesion, Vascularization and Surrounding tissue.
CT-imaging findings in CLA are broad and nomenclature is variable. Overlap is seen between and within abnormalities, possibly due to definitions often being based on pathological findings, which is an unsuitable approach for CT imaging. We propose a structured assessment of CLA using objective radiological features and uniform nomenclature to improve reporting.
制定一个用于对 CT 扫描中先天性肺异常（CLA）进行结构化评估和统一报告的临床指南。
对描述先天性肺气道畸形（CPAM）、支气管肺隔离症（BPS）、先天性肺大疱（CLE）和支气管囊肿（BC）的 CT 扫描异常的文献进行系统检索。在儿科肺科医生、放射科医生和外科医生之间达成共识后，开发了一种使用 CLA 客观特征的结构化报告。
在对两名独立审查员进行标题-摘要筛选后，从 1581 篇文章中确定了 158 篇。在评估全文后，我们纳入了 28 项回顾性队列研究。含气囊肿和软组织肿块在 CPAM 和 BPS 中均有描述，而异常动脉血液供应仅在 BPS 中发现。病变周围的低衰减区、肺不张和纵隔移位可能存在于所有上述异常中，也可能存在于 CLE 中，作为肺过度充气的原因。我们已经开发了一个结构化报告，分为五个部分：位置和范围、气道、病变、血管化和周围组织。
CLA 的 CT 成像表现广泛，命名法也各不相同。异常之间和内部存在重叠，这可能是由于定义通常基于病理发现，这对于 CT 成像来说不是一个合适的方法。我们建议使用客观的影像学特征和统一的命名法对 CLA 进行结构化评估，以改善报告。
