Department of Radiology, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, No. 56, Nanlishilu Road, Xicheng District, Beijing, 100045, People's Republic of China.
Department of Neonatal Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
Pediatr Radiol. 2023 May;53(6):1063-1075. doi: 10.1007/s00247-023-05610-z. Epub 2023 Feb 27.
Communicating bronchopulmonary foregut malformation is a rare anomaly characterized by a patent congenital communication between the esophagus or stomach and an isolated portion of the respiratory system. An esophagogram is taken as the gold standard for diagnosis. Compared with esophagography, computed tomography (CT) is more widely used and easily obtained, but CT findings have been described as nonspecific.
To describe CT findings in 18 patients with communicating bronchopulmonary foregut malformation to assist with early diagnosis.
A retrospective review of 18 patients who had proven communicating bronchopulmonary foregut malformation between January 2006 and December 2021 was conducted. For each patient, the medical records, including demographics, clinical manifestations, upper gastrointestinal radiography, magnetic resonance imaging and CT findings, were reviewed.
Among the 18 patients, there were 8 males. The right to left ratio was 3.5:1. An entire lung was involved in 10 patients, a lobe or a segment was involved in 7 patients and an ectopic lesion was located in the right neck in 1 patient. The isolated lung may arise from the upper esophagus, mid-esophagus, lower esophagus or stomach, which were detected in 1, 3, 13, and 1 patient, respectively. On chest CT, an extra bronchus which did not arise from the trachea was detected in 14 patients. Contrast-enhanced chest CT was performed in 17 patients, the isolated lung receiving its blood supply from the pulmonary artery in 13 patients, the systemic artery in 11 patients and both pulmonary and systemic arteries in 7 patients.
The presence of an extra bronchus, which does not arise from the trachea, highly suggests the diagnosis of communicating bronchopulmonary foregut malformation. Contrast-enhanced chest CT can provide accurate information regarding the airways, lung parenchyma and vascular structures that is useful to plan surgery.
沟通性支气管肺前肠畸形是一种罕见的异常，其特征是先天性食管或胃与孤立的呼吸系统之间存在通畅的交通。食管造影被视为诊断的金标准。与食管造影相比，计算机断层扫描（CT）应用更广泛且易于获得，但 CT 表现被描述为非特异性。
描述 18 例沟通性支气管肺前肠畸形患者的 CT 表现，以协助早期诊断。
回顾性分析 2006 年 1 月至 2021 年 12 月期间经证实的 18 例沟通性支气管肺前肠畸形患者。对每位患者的病历资料进行了回顾，包括人口统计学、临床表现、上消化道造影、磁共振成像和 CT 表现。
18 例患者中，男性 8 例，男女比为 3.5:1。10 例累及整个肺，7 例累及肺叶或肺段，1 例异位病变位于右侧颈部。孤立的肺可能起源于上食管、中食管、下食管或胃，分别在 1、3、13 和 1 例患者中检测到。14 例患者在胸部 CT 上检测到一个不源自气管的额外支气管。17 例患者进行了增强胸部 CT 检查，13 例孤立肺的血供来自肺动脉，11 例来自体循环动脉，7 例来自肺循环和体循环动脉。
存在不源自气管的额外支气管高度提示诊断为沟通性支气管肺前肠畸形。增强胸部 CT 可以提供有关气道、肺实质和血管结构的准确信息，有助于计划手术。
