European Radiology

, Volume 27, Issue 6, pp 2489–2496 | Cite as

Extralobar pulmonary sequestration in neonates: The natural course and predictive factors associated with spontaneous regression

  • Hee Mang Yoon
  • Ellen Ai-Rhan Kim
  • Sung-Hoon Chung
  • Seon-Ok Kim
  • Ah Young Jung
  • Young Ah Cho
  • Chong Hyun Yoon
  • Jin Seong Lee
Paediatric

Abstract

Purpose

To describe the natural course of extralobar pulmonary sequestration (EPS) and identify factors associated with spontaneous regression of EPS.

Materials and methods

We retrospectively searched for patients diagnosed with EPS on initial contrast CT scan within 1 month after birth and had a follow-up CT scan without treatment. Spontaneous regression of EPS was assessed by percentage decrease in volume (PDV) and percentage decrease in sum of the diameter of systemic feeding arteries (PDD) by comparing initial and follow-up CT scans. Clinical and CT features were analysed to determine factors associated with PDV and PDD rates.

Results

Fifty-one neonates were included. The cumulative proportions of patients reaching PDV > 50 % and PDD > 50 % were 93.0 % and 73.3 % at 4 years, respectively. Tissue attenuation was significantly associated with PDV rate (B = −21.78, P < .001). The tissue attenuation (B = −22.62, P = .001) and diameter of the largest systemic feeding arteries (B = −48.31, P = .011) were significant factors associated with PDD rate.

Conclusion

The volume and diameter of systemic feeding arteries of EPS spontaneously decreased within 4 years without treatment. EPSs showing a low tissue attenuation and small diameter of the largest systemic feeding arteries on initial contrast-enhanced CT scans were likely to regress spontaneously.

Key Points

Extralobar pulmonary sequestration (EPS) could show spontaneous regression.

Initial CT features may predict spontaneous regression of EPS.

The tissue attenuation and diameter of systemic feeding artery are important factors.

Keywords

Extralobar pulmonary sequestration Natural course Spontaneous regression Neonate Computed tomography 

Abbreviations

CI

Confidence interval

CT

Computed tomography

EPS

Extralobar pulmonary sequestration

PDD

Percentage decrease in the sum of the diameters of all of the systemic feeding arteries

PDV

Percentage decrease in volume

ROI

Region of interest

SD

Standard deviation

SFAs

Systemic feeding arteries

Notes

Acknowledgments

The scientific guarantor of this publication is Jin Seong Lee. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. One of the authors (Seon Ok Kim) has significant statistical expertise. Institutional Review Board approval was obtained. Written informed consent was waived by the Institutional Review Board. Methodology: retrospective, observational, performed at one institution.

Supplementary material

330_2016_4594_MOESM1_ESM.docx (24 kb)
Table A1 (DOCX 24 kb)
330_2016_4594_MOESM2_ESM.docx (25 kb)
Table A2 (DOCX 25 kb)
330_2016_4594_MOESM3_ESM.docx (24 kb)
Table A3 (DOCX 24 kb)

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Copyright information

© European Society of Radiology 2016

Authors and Affiliations

  • Hee Mang Yoon
    • 1
  • Ellen Ai-Rhan Kim
    • 2
  • Sung-Hoon Chung
    • 3
  • Seon-Ok Kim
    • 4
  • Ah Young Jung
    • 1
  • Young Ah Cho
    • 1
  • Chong Hyun Yoon
    • 1
  • Jin Seong Lee
    • 1
  1. 1.Department of Radiology and Research Institute of RadiologyAsan Medical Center Children’s Hospital, University of Ulsan College of MedicineSongpa-guKorea
  2. 2.Division of Neonatology, Asan Medical Center Children’s HospitalUniversity of Ulsan College of MedicineSeoulKorea
  3. 3.Department of PediatricsKyung Hee University School of MedicineSeoulKorea
  4. 4.Department of Clinical Epidemiology & BiostatisticsAsan Medical CenterSeoulKorea

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