CT angiography as a main method of diagnostics of rear forms of congenital pulmonary malformations in newborns

Abstract

Relevance. Congenital pulmonary abnormalities are revealed considerably more often than it was supposed. In many children, they represent the main reason for development of inflammatory process or respiratory failure. The improvement of diagnostic methods resulted in the fact that congenital pulmonary malformations are diagnosed in children of early age and even in the neonatal period. For the correct choice of treatment tactics and timing in congenital pulmonary malformations in newborns, it is very important to differentiate among several types of malformations, including congenital cystic adenomatoid malformation, pulmonary sequestrations, bronchogenic and enterogenic cysts, and also bronchial atresia. Objective. To estimate possibilities of a chest computer tomographic angiography in the differential diagnosis of rare lung malformations in newborns. Materials and methods. The study included results of complex evaluation of 65 newborns, in which according to prenatal ultrasonic investigation, congenital cystic adenomatoid malformation were assumed. The utility of computer tomographic angiography in newborns, possibilities of a method in differentiation of congenital pulmonary malformations are defined. Results. In 27 patients, the postnatal computer tomography confirmed the diagnosis of congenital cystic adenomatoid malformations. In 38 patients, other malformations requiring surgical treatment were diagnosed. 61 children were subjected to surgical treatment. In 4 children, surgical treatment was not performed, and they were supervised by a pulmonologist. Questions of differential diagnostics of rare congenital pulmonary malformations in newborns as well as the comparison of our own results with the data of literature are considered. Conclusions. In the differential diagnosis of lung malformations in newborns, chest computer tomographic angiography can be used as the main method alternative to invasive procedures. Tactics of further surgical treatment of such patients in the newborn and later periods should be based on the results of chest computer tomographic angiography and depends on the identified lung malformation.