Maimon S, Siplovich L, Kaveh Z, Shalev E, Vigder F
Radiology Dept., Central Hospital of the Emek, Afula.
Harefuah. 1994 Jul;127(1-2):18-21, 63.
Pulmonary sequestration is part of the spectrum of bronchopulmonary foregut anomaly. It is a rare type of congenital malformation in which a mass of pulmonary tissue is separate from the normal lung and receives its arterial supply directly from the systemic circulation. Angiographic demonstration of a systemic artery leading to the sequestrated lung has usually been used to diagnose this condition. In the past 10 years cases of this rare anomaly have been detected and diagnosed by ultrasonography in the pre- and postnatal period. We describe a very rare case of intraabdominal, extralobar pulmonary sequestration detected in the antenatal period. Ultrasonography showed a hyperechoic subdiaphragmatic mass above the left kidney, near the aorta. In the mass were 2 echo-free vascular structures. 2 arterial branches originating from the abdominal aorta which traversed the subdiaphragmatic mass. The near-diaphragmatic location of many pulmonary sequestrations provides an excellent acoustic window for sonographic detection. MRI can help in the diagnosis when ultrasonographic findings are equivocal. Ultrasound and MRI will soon replace aortic angiography in the diagnosis of this condition in the pre- and postnatal period, pulmonary sequestration should be included in the differential diagnosis of upper abdominal masses identified by ultrasonography.
肺隔离症是支气管肺前肠畸形谱系的一部分。它是一种罕见的先天性畸形，其中一团肺组织与正常肺分离，并直接从体循环接受其动脉供应。通常使用血管造影显示一条体动脉通向隔离肺来诊断这种情况。在过去10年中，这种罕见畸形的病例已在产前和产后通过超声检查被发现和诊断。我们描述了一例在产前发现的非常罕见的腹内、叶外型肺隔离症。超声检查显示左肾上方、靠近主动脉处有一个高回声的膈下肿块。肿块内有2个无回声血管结构。2条动脉分支起源于腹主动脉，穿过膈下肿块。许多肺隔离症靠近膈肌的位置为超声检查提供了极好的声学窗口。当超声检查结果不明确时，MRI有助于诊断。超声和MRI将很快取代主动脉造影用于产前和产后这种疾病的诊断，肺隔离症应包括在超声检查发现的上腹部肿块的鉴别诊断中。
