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Predicting Pathology From Imaging in Children Undergoing Resection of Congenital Lung Lesions.
- Source :
-
The Journal of surgical research [J Surg Res] 2019 Apr; Vol. 236, pp. 68-73. Date of Electronic Publication: 2018 Dec 07. - Publication Year :
- 2019
-
Abstract
- Background: Prenatal magnetic resonance imaging (MRI) is increasingly obtained to define congenital lung lesions (CLL) for surgical management. Postnatal, preoperative computed tomography (CT) provides further clarity at the cost of radiation. Depending on the lesion identified, the indication for resection remains controversial. We investigated the differences in detail found on prenatal MRI and postnatal CT compared with final pathology to determine their utility in preoperative decision-making.<br />Materials and Methods: All children undergoing resection of CLLs at a single institution between July 2009 and February 2018 were retrospectively identified. Their imaging, operative, and pathology reports were compared. All imaging studies were examined by pediatric radiologists with experience in prenatal CLL diagnosis.<br />Results: Fifty-five patients underwent CLL resection during the study period with 31 undergoing prenatal MRI, 45 postnatal CT, and 22 both. Resection was performed before 6 mo of age in 62% of patients. In the cohort undergoing both imaging studies, pathologic CLL diagnosis correlated with prenatal MRI and CT in 82% and 100% of patients, respectively (P = 0.13). Eight patients had systemic feeding vessels, of which 38% were identified on MRI, and 88% on CT (P = 0.13). Both studies had a specificity of 100% for detecting systemic feeding vessels.<br />Conclusions: For children where prenatal MRI detected a systemic feeding vessel, CT was redundant for preoperative planning but had greater sensitivity. Ultimately, the CLL type predicted from postnatal CT was not significantly different from that predicted by prenatal MRI; however, both imaging modalities had some level of discrepancy with pathology.<br /> (Copyright © 2018 Elsevier Inc. All rights reserved.)
- Subjects :
- Female
Humans
Infant
Lung diagnostic imaging
Lung surgery
Lung Diseases congenital
Lung Diseases surgery
Male
Patient Care Planning
Pneumonectomy
Pregnancy
Prenatal Diagnosis methods
Preoperative Period
Respiratory System Abnormalities surgery
Retrospective Studies
Sensitivity and Specificity
Clinical Decision-Making methods
Lung pathology
Lung Diseases diagnostic imaging
Magnetic Resonance Imaging
Respiratory System Abnormalities diagnostic imaging
Tomography, X-Ray Computed
Subjects
Details
- Language :
- English
- ISSN :
- 1095-8673
- Volume :
- 236
- Database :
- MEDLINE
- Journal :
- The Journal of surgical research
- Publication Type :
- Academic Journal
- Accession number :
- 30694781
- Full Text :
- https://doi.org/10.1016/j.jss.2018.10.042