ISSN: 1899-0967
Polish Journal of Radiology
Established by prof. Zygmunt Grudziński in 1926 Sun
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1/2023
vol. 88
 
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Pediatric radiology
abstract:
Original paper

Congenital lung malformations: can we avoid computed tomography? A five-year study

Filomena Carfagnini
1
,
Donatella Vivacqua
1
,
Michelangelo Baldazzi
1
,
Laura Marcolin
1
,
Stefano Giusto Picchi
2
,
Giulia Lassandro
2
,
Igino Simonetti
3
,
Piero Trovato
4
,
Giuliana Giacobbe
5
,
Antonio Corvino
6
,
Laura Greco
1

1.
Radiology Unit, Department of Experimental, Diagnostic and Speciality Medicine, Sant’Orsola Hospital, University of Bologna, Bologna, Italy
2.
General and Interventional Radiology, Diagnostic Imaging Department, Oncological Radiotherapy and Haematology, Diagnostic Imaging Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
3.
Radiology Division, “Istituto Nazionale Tumori – IRCCS – Fondazione G. Pascale, Napoli, Italia”, Naples, Italy
4.
Radiology Unit, “Santa Maria delle Grazie” Hospital, Pozzuoli, Italy
5.
Department of Precision Medicine, University of Campania “L. Vanvitelli”, Naples, Italy
6.
Movement Sciences and Wellbeing Department, University of Naples “Parthenope”, Naples, Italy
Pol J Radiol 2022; 87: e1-e9
Online publish date: 2023/01/05
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Purpose
Congenital lung malformations (CLMs) consist of a variety of pulmonary development disorders. In the CLM approach, computed tomography (CT) is considered the gold standard imaging technique due to the high-resolution for the lung parenchyma evaluation, the study of the vascular system after contrast injection, and the multiplanar reconstructions. In the paediatric population CT is considered too invasive due to ionizing radiation and the use of contrast agent. Therefore, the indications for the use of magnetic resonance imaging (MRI) are increasing. The aim of our study is to compare retrospectively MRI and CT in the evaluation of CLMs, to reduce or avoid the use of contrast-enhanced CT in the paediatric population.

Material and methods
We retrospectively evaluated 22 paediatric patients with prenatal diagnosis of CLMs. All the patients underwent postnatal MRI in the first 2 weeks of life (except for a patient) and pre-surgery contrast-enhanced CT. A total of 7 blinded radiologists divided into 3 different groups independently reviewed each MRI and CT examination. Sensitivity and specificity of radiologists with different years of experience on the field, as well as of MRI findings regarding every pathology, were evaluated using a ROC curve. The interobserver agreement regarding the MRI findings was also measured.

Results
Analysing the ROC curves, we observed that MRI provided a satisfactory accuracy for diagnosing most congenital pulmonary diseases.

Conclusions
Our study showed that MRI without contrast agent allows us to reach a CLM diagnosis in good agreement with contrast-enhanced CT, which is considered the gold standard imaging technique.

keywords:

computed tomography, infant, magnetic resonance imaging, lung diseases, bronchopulmonary sequestration, contrast media




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