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Pediatric Congenital Lung Malformation: Advanced Imaging Techniques in Pre- and Neonatal Evaluation
Gabriele Masselli1, Chiara Di Bella1, George Hadjidekov2
1Department of Radiological Sciences, Oncology and Pathology, Policlinico Umberto I, Sapienza University of Rome, 00161 Rome, Italy.
Insights
Congenital lung malformations (CLMs) in children are best diagnosed with postnatal imaging. Chest CT angiography is the primary postnatal imaging tool for CLMs.
Area of Science:
- Pediatric Radiology
- Thoracic Imaging
- Congenital Anomalies
Background:
- Congenital lung malformations (CLMs) represent a range of developmental abnormalities affecting lung structures.
- Prenatal diagnosis is increasing, but postnatal imaging remains crucial for characterization.
Purpose of the Study:
- To present current imaging strategies for pediatric CLMs.
- To review radiologic findings and clinical features of CLMs.
Main Methods:
- Review of contemporary imaging approaches for pediatric CLMs.
- Discussion of fetal ultrasound (US) and MRI, and postnatal chest CT angiography (CTA) and MR imaging (MR)/MR angiography (MRA).
Main Results:
- Chest CTA is typically the initial postnatal imaging modality for asymptomatic infants and children with suspected CLMs.
- Fetal US and MRI are used for prenatal monitoring.
- MR imaging/MRA can serve as a complementary tool in fetal and neonatal periods.
Conclusions:
- Postnatal imaging is key for characterizing pediatric CLMs.
- Chest CTA is the preferred initial postnatal imaging modality.
- Imaging management is guided by symptoms and institutional protocols.
Abstract:
Pediatric congenital lung malformations (CLMs) comprise a spectrum of developmental anomalies of lung parenchyma, airways, and vasculature. CLMs are increasingly diagnosed prenatally but remain best characterized by postnatal cross-sectional imaging. During pregnancy, ultrasound (US) and fetal magnetic resonance imaging (MRI) are commonly used to monitor lung lesions. Management of CLMs, including imaging, in infants and young children depends on associated symptoms and institutional standards. Chest CT angiography (CTA) is usually the most appropriate initial postnatal imaging modality for assessing prenatally diagnosed or clinically suspected CLMs in asymptomatic infants and children. Magnetic resonance (MR) imaging/magnetic resonance angiography (MRA) may be considered as a complementary, problem-solving, imaging modality for evaluation of CLMs during fetal and neonatal periods. This article presents contemporary perspectives on the imaging approach to pediatric patients with suspected CLMs and reviews up-to-date radiologic findings and clinical characteristics of CLMs.
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