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

  • Paediatric
  • Published:
European Radiology Aims and scope Submit manuscript

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.

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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

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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.

Author information

Authors and Affiliations

  1. Department of Radiology and Research Institute of Radiology, Asan Medical Center Children’s Hospital, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Korea

    Hee Mang Yoon, Ah Young Jung, Young Ah Cho, Chong Hyun Yoon & Jin Seong Lee

  2. Division of Neonatology, Asan Medical Center Children’s Hospital, University of Ulsan College of Medicine, Seoul, Korea

    Ellen Ai-Rhan Kim

  3. Department of Pediatrics, Kyung Hee University School of Medicine, Seoul, Korea

    Sung-Hoon Chung

  4. Department of Clinical Epidemiology & Biostatistics, Asan Medical Center, Seoul, Korea

    Seon-Ok Kim

Authors
  1. Hee Mang Yoon
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  2. Ellen Ai-Rhan Kim
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  3. Sung-Hoon Chung
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  4. Seon-Ok Kim
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  5. Ah Young Jung
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  6. Young Ah Cho
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  7. Chong Hyun Yoon
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  8. Jin Seong Lee
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Corresponding author

Correspondence to Jin Seong Lee.

Additional information

Hee Mang Yoon and Ellen Ai-Rhan Kim contributed equally to this work and should be considered as co-first authors.

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Yoon, H.M., Kim, E.AR., Chung, SH. et al. Extralobar pulmonary sequestration in neonates: The natural course and predictive factors associated with spontaneous regression. Eur Radiol 27, 2489–2496 (2017). https://doi.org/10.1007/s00330-016-4594-x

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  • DOI: https://doi.org/10.1007/s00330-016-4594-x

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