Shaun M Kunisaki1, Stacey Ehrenberg-Buchner2, Jonathan R Dillman3, Ethan A Smith3, George B Mychaliska4, Marjorie C Treadwell2. 1. Department of Surgery, Section of Pediatric Surgery, C.S. Mott Children's and Von Voigtlander Women's Hospital, University of Michigan Health System, Ann Arbor, MI, USA; Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, C.S. Mott Children's and Von Voigtlander Women's Hospital, University of Michigan Health System, Ann Arbor, MI, USA. Electronic address: shaunkun@umich.edu. 2. Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, C.S. Mott Children's and Von Voigtlander Women's Hospital, University of Michigan Health System, Ann Arbor, MI, USA. 3. Department of Radiology, Section of Pediatric Radiology, C.S. Mott Children's and Von Voigtlander Women's Hospital, University of Michigan Health System, Ann Arbor, MI, USA. 4. Department of Surgery, Section of Pediatric Surgery, C.S. Mott Children's and Von Voigtlander Women's Hospital, University of Michigan Health System, Ann Arbor, MI, USA; Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, C.S. Mott Children's and Von Voigtlander Women's Hospital, University of Michigan Health System, Ann Arbor, MI, USA.
Abstract
BACKGROUND/ PURPOSE: The purpose of this study was to examine the natural history and outcomes of prenatally diagnosed lung masses that appear to undergo complete regression before birth. METHODS: An IRB-approved retrospective review was performed on 100 consecutive fetuses with a congenital lung malformation at a single fetal center. Prenatal and postnatal imaging as well as outcomes of vanishing fetal masses was analyzed and compared to those with persistent fetal masses. RESULTS: Seventeen lesions (17%) became sonographically undetectable at 35.3 ± 2.3 weeks gestation. Vanishing fetal masses were associated with microcystic disease (100% vs. 69%, p=0.005) and a low initial congenital pulmonary airway malformation volume ratio (CVR; 0.31 ± 0.35 vs. 0.70 ± 0.66, p=0.002) when compared to those with persistent fetal lesions. Based on postnatal CT imaging and pathology data, 10.3% of all fetal masses completely regressed. The positive predictive value and negative predictive value of prenatal ultrasound for detecting lung malformations in late gestation were 96% and 43%, respectively. All infants with vanishing fetal lesions were asymptomatic at birth and were more likely to be managed nonoperatively (75% vs. 22%, p<0.0001) when compared to infants with persistent fetal masses. CONCLUSIONS: Vanishing lung lesions late in gestation are relatively common and are associated with a low CVR and microcystic disease.
BACKGROUND/ PURPOSE: The purpose of this study was to examine the natural history and outcomes of prenatally diagnosed lung masses that appear to undergo complete regression before birth. METHODS: An IRB-approved retrospective review was performed on 100 consecutive fetuses with a congenital lung malformation at a single fetal center. Prenatal and postnatal imaging as well as outcomes of vanishing fetal masses was analyzed and compared to those with persistent fetal masses. RESULTS: Seventeen lesions (17%) became sonographically undetectable at 35.3 ± 2.3 weeks gestation. Vanishing fetal masses were associated with microcystic disease (100% vs. 69%, p=0.005) and a low initial congenital pulmonary airway malformation volume ratio (CVR; 0.31 ± 0.35 vs. 0.70 ± 0.66, p=0.002) when compared to those with persistent fetal lesions. Based on postnatal CT imaging and pathology data, 10.3% of all fetal masses completely regressed. The positive predictive value and negative predictive value of prenatal ultrasound for detecting lung malformations in late gestation were 96% and 43%, respectively. All infants with vanishing fetal lesions were asymptomatic at birth and were more likely to be managed nonoperatively (75% vs. 22%, p<0.0001) when compared to infants with persistent fetal masses. CONCLUSIONS:Vanishing lung lesions late in gestation are relatively common and are associated with a low CVR and microcystic disease.
Authors: Rachel Shulman; Teresa N Sparks; Kristen Gosnell; Cinthia Blat; Mary E Norton; Hanmin Lee; Juan Gonzalez-Velez; Ruth B Goldstein Journal: Am J Perinatol Date: 2018-09-10 Impact factor: 1.862
Authors: Daniel T Swarr; William H Peranteau; Jennifer Pogoriler; David B Frank; N Scott Adzick; Holly L Hedrick; Mike Morley; Su Zhou; Edward E Morrisey Journal: Am J Respir Crit Care Med Date: 2018-05-15 Impact factor: 30.528