Imaging of congenital cystic lung lesions

Congenital cystic lung lesions are a rare but clinically significant group of anomalies, including congenital cystic adenomatoid malformation (CCAM), pulmonary sequestration, congenital lobar emphysema (CLE) and bronchogenic cysts. These conditions can all present on imaging studies as air or fluid filled cysts. Widespread use of antenatal ultrasound has led to increased detection of infants with congenital thoracic abnormalities in utero, resulting in a better understanding of the natural history of many of these lesions and also allowing provision to be made for delivery and postnatal management. More recently antenatal magnetic resonance (MR) imaging has provided further information on the nature of many of these lesions and helped to differentiate them from extrathoracic abnormalities such as congenital diaphragmatic hernia (CDH), which is important in parental counselling. Many children with congenital cystic lung lesions will present with symptoms resulting in the need for prompt diagnosis and treatment and imaging has an essential role in the management of these children. Some congenital lung lesions are treated surgically, whilst others are managed conservatively.