Peng Yongxuan, Xu Yuejuan, Tang Jiazhong, Qian Ziling, Hu Jie, Liu Wei, Xia Yulian, Sun Xin, Sun Kun, Bai Kai, Lu Yanan
Department of Pediatric Heart Center, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Department of Pediatric Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University; Engineering Center for Congenital Heart Disease Device Diagnosis and Treatment, Ministry of Education, Shanghai, China.
Front Pediatr. 2025 May 23;13:1576380. doi: 10.3389/fped.2025.1576380. eCollection 2025.
OBJECTIVE: The surgical treatment of congenital pulmonary airway malformations (CPAM) remains a subject of debate. This study aimed to deeply analyze the preoperative CT imaging data to explore the anatomical characteristics of CPAM lesions, providing additional information to guide surgical treatment for such conditions. METHODS: A retrospective analysis was conducted on the medical records of children with congenital pulmonary airway malformations who underwent surgery between 2020 and 2024 at our hospital. Preoperative CT images were processed using 3D Slicer software to analyze the volume, external boundaries, vascular and airway branching, and resection planes (lung venous branch planes) of the lesions. The primary analysis indicators included lesion volume, the volume ratio of the lesion to the affected lung lobe, and the real airway, artery, and venous branches supplying the lesion, as well as the airway, artery, and venous branches that might be severed during resection. RESULTS: A total of 17 cases and 18 corresponding preoperative CT images were included, with 7 cases using enhanced CT scans. The mean age of the patients was 68.9 ± 38.9 months. Most lesions (72.2%) were located in the lower lung. The average volume of the lesions was 47.5 cm (range: 25.6-91.4 cm), which occupied 26.6 ± 12.7% of the affected lung lobe. There was no significant correlation between lesion volume and age ( = 0.25), and a weak negative correlation between the volume ratio and age ( = -0.48). The proportion of lesions with real supplying airway, artery, and venous branches was 16.7%, 77.8%, and 83.3%, respectively. The proportions of lesions requiring the severance of additional airway, artery, and venous branches during resection were 27.8%, 16.7%, and 5.5%, respectively. The external boundaries of the lesions were most clearly exposed. CONCLUSION: The use of preoperative CT imaging and corresponding image processing software allows for a comprehensive analysis of the anatomical characteristics of congenital pulmonary airway malformation lesions. This may help improve the understanding of CPAM and the effectiveness of lesion resection surgeries.
目的：先天性肺气道畸形（CPAM）的外科治疗仍是一个有争议的话题。本研究旨在深入分析术前CT影像数据，以探索CPAM病变的解剖特征，为指导此类疾病的外科治疗提供更多信息。 方法：对2020年至2024年在我院接受手术的先天性肺气道畸形患儿的病历进行回顾性分析。使用3D Slicer软件处理术前CT图像，以分析病变的体积、外部边界、血管和气道分支以及切除平面（肺静脉分支平面）。主要分析指标包括病变体积、病变与患肺叶的体积比、供应病变的真实气道、动脉和静脉分支，以及切除过程中可能被切断的气道、动脉和静脉分支。 结果：共纳入17例及18幅相应的术前CT图像，其中7例使用增强CT扫描。患者的平均年龄为68.9±38.9个月。大多数病变（72.2%）位于下肺。病变的平均体积为47.5 cm（范围：25.6 - 91.4 cm），占患肺叶的26.6±12.7%。病变体积与年龄之间无显著相关性（=0.25），体积比与年龄之间呈弱负相关（=-0.48）。具有真实供应气道、动脉和静脉分支的病变比例分别为16.7%、77.8%和83.3%。切除过程中需要切断额外气道、动脉和静脉分支的病变比例分别为27.8%、16.7%和5.5%。病变的外部边界显示最为清晰。 结论：术前CT成像及相应图像处理软件的使用能够全面分析先天性肺气道畸形病变的解剖特征。这可能有助于提高对CPAM的认识以及病变切除手术的有效性。
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