Imaging of medical disease of the newborn lung.

Surfactant deficiency remains the most common and serious pulmonary affliction of premature infants. Exogenous surfactant and corticosteroid administration have had a major impact in improving survival and morbidity in this disease with consequent alterations in the clinical and radiographic course. Chronic lung disease, although still common, is usually less severe than previously, especially in larger infants. Significant therapeutic strides in treating persistent pulmonary hypertension with or without meconium aspiration have been the use of high-frequency ventilators, inhaled nitric oxide, and ECMO. Prompt recognition and treatment of infection, atelectasis, and air leak whether primary or secondary are important to overall outcome. Less common pulmonary conditions, such as lymphangiectasia, pulmonary hypoplasia, and alveolar proteinosis, may initially masquerade as more common lesions. Persistent pulmonary hypertension is often the initial diagnosis and part of the clinical problem. Attention must be paid to the clinical and radiographic appearance and excursion of the thoracic cage because deformities and malformations may be the cause of respiratory problems.