Perinatal Thoracic Mass Lesions: Pre- and Postnatal Imaging
Evan J Zucker1, Monica Epelman2, Beverley Newman1
1Department of Radiology, Stanford University School of Medicine, Lucile Packard Children's Hospital, Stanford, CA.
Insights
Prenatal imaging detects fetal chest masses, often bronchopulmonary malformations. Differentiating these from other thoracic pathologies using clinical and imaging features aids in timely infant management and prognostication.
Area of Science:
- Perinatal medicine
- Pediatric radiology
- Thoracic imaging
Background:
- Chest masses are common in newborns, requiring accurate diagnosis.
- Prenatal ultrasound and fetal MRI enable early detection of thoracic lesions.
- Bronchopulmonary malformations are the most frequent cause of fetal chest masses.
Purpose of the Study:
- To review the diagnostic approaches for fetal chest masses.
- To highlight the differentiation between bronchopulmonary malformations and other thoracic pathologies.
- To emphasize the importance of clinical and imaging features for management.
Main Methods:
- Review of current literature on fetal thoracic imaging.
- Analysis of clinical presentations and imaging characteristics of various chest masses.
- Discussion of diagnostic algorithms for perinatal chest lesions.
Main Results:
- Prenatal imaging allows for detailed characterization of thoracic lesions.
- Postnatal imaging may be deferred in asymptomatic infants.
- Accurate differentiation of mass types is crucial for surgical planning and outcomes.
Conclusions:
- Understanding key differentiating features is essential for optimizing prognostication.
- Timely and accurate diagnosis of fetal chest masses improves infant management.
- Multimodality imaging plays a critical role in evaluating congenital thoracic abnormalities.
Abstract:
Chest masses present a common problem in the perinatal period. Advances in prenatal ultrasound, supplemented by fetal magnetic resonance imaging, now allow early detection and detailed characterization of many thoracic lesions in utero. As such, in asymptomatic infants, assessment with postnatal computed tomography or magnetic resonance imaging can often be delayed for several months until the time at which surgery is being contemplated. Bronchopulmonary malformations comprise most of the thoracic masses encountered in clinical practice. However, a variety of other pathologies can mimic their appearances or produce similar effects such as hypoplasia of a lung or both lungs. Understanding of the key differentiating clinical and imaging features can assist in optimizing prognostication and timely management.
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