Lung Ultrasound: A New Tool in the Management of Congenital Lung Malformation

Abstract

Objective This study was aimed to evaluate effectiveness of lung ultrasound (LUS) in the management of congenital pulmonary airway malformation and pulmonary sequestration in NICUs.

Study Design This is a nonconsecutive case series of neonates admitted to the academic NICU of Policlinico of Bari, Italy, from 2010 to 2018, for suspected lung malformations and examined by LUS.

Results Seven neonates were admitted for suspected pulmonary malformations, four neonates were diagnosed with pulmonary sequestration and three with congenital pulmonary airway malformation either type I (two cases) or type II (one case) according to Adzick classification. Prenatal scans had described lung malformations in six patients. Two underwent surgical intervention during the 1st month of life. All were successfully discharged home and their follow-up has been uneventful thereafter. In all the seven neonates, LUS easily detected the lesion showing a significantly high correspondence with computed tomography (CT) scan findings.

Conclusion We described the first case series of neonates affected by complex pulmonary malformations, assessed by LUS. In our experience, LUS was safe and effective for the diagnosis with high degree of consistency with CT scan findings. We suggest that LUS might be an important diagnostic method for lung malformations in newborns and a useful technique for their follow-up and late management, avoiding multiple exposures to radiations.

Keywords

lung ultrasound - congenital pulmonary airway malformation - pulmonary sequestration - congenital diaphragmatic hernia

What is Known about the Topic?

Congenital Pulmonary Airway Malformation and PS are rare malformations, usually diagnosed on prenatal scans. CT scan and CT angiography scan are the preferred imaging techniques for the postnatal management of CPAM and PS, respectively. Surgical repair is necessary in selected cases only.

What Does this Study Add?

LUS is useful in addition to traditional imaging techniques for the diagnosis and follow-up of pulmonary malformations. LUS and CT scan findings present a high degree of consistency. Single or multiple hypoechoic cysts of various dimensions and lung consolidation on LUS might be suggestive of pulmonary malformations.

Note

Parental informed consent was obtained from all patients.

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