Document Detail

CT findings and temporal course of persistent pulmonary interstitial emphysema in neonates: a multiinstitutional study.
MedLine Citation:
PMID:  12646469     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: The purpose of this study was to evaluate the CT appearance, management, and temporal course of persistent pulmonary interstitial emphysema in neonates. MATERIALS AND METHODS: Criteria for inclusion in the study group included neonates with a history of prematurity who required ventilation for lung disease, development of hyperexpanded radiolucent lung lesions after typical radiographic findings of pulmonary interstitial emphysema, and CT documentation of lung abnormalities. Radiographs and CT scans were reviewed for the anatomic distribution, appearance, and presence of classic lines or dots within a radiolucent mass. We compared the management (surgical vs nonsurgical) and the temporal course in nonsurgical cases for patients in the United States and patients outside the United States. RESULTS: From seven institutions, we identified 17 patients who had persistent pulmonary interstitial emphysema with CT documentation. On CT, all lesions consisted of hyperexpanded cystic radiolucencies. Distribution was single-lobe in nine patients (left upper lobe, n = 5; left lower lobe, n = 3; right middle lobe, n = 1), multilobar in eight patients, and bilateral in six patients. Fourteen patients (82%) showed the characteristic line-and-dot pattern. All patients were initially treated conservatively; nine eventually underwent surgical resection with confirmation at pathology. Of 10 patients who underwent nonsurgical treatment for at least 1 year, lesions resolved in four patients, decreased in size in three asymptomatic patients, and enlarged in three patients, with eventual resection in two. Surgical resection was performed in 89% (8/9) of patients treated in the United States and in 13% (1/8) of patients treated outside the United States. CONCLUSION: Our study found that 82% of patients with persistent pulmonary interstitial emphysema had characteristic CT findings (central lines and dots surrounded by radiolucency). Although most patients in this series eventually underwent surgical resection, initial treatment can be conservative. The decision to perform surgery may have reflected the local medical culture.
Lane F Donnelly; Javier Lucaya; Vanildo Ozelame; Donald P Frush; Peter J Strouse; Thomas E Sumner; Harriet J Paltiel
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  AJR. American journal of roentgenology     Volume:  180     ISSN:  0361-803X     ISO Abbreviation:  AJR Am J Roentgenol     Publication Date:  2003 Apr 
Date Detail:
Created Date:  2003-03-20     Completed Date:  2003-04-30     Revised Date:  2008-02-15    
Medline Journal Info:
Nlm Unique ID:  7708173     Medline TA:  AJR Am J Roentgenol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1129-33     Citation Subset:  AIM; IM    
Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., Cincinnati, OH 45229-3039, USA.
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MeSH Terms
Child, Preschool
Chronic Disease
Follow-Up Studies
Infant, Newborn
Infant, Premature, Diseases / etiology,  radiography*,  surgery
Lung, Hyperlucent / etiology,  radiography,  surgery
Outcome and Process Assessment (Health Care)
Postoperative Complications / radiography
Pulmonary Emphysema / etiology,  radiography*,  surgery
Respiration, Artificial / adverse effects
Sensitivity and Specificity
Tomography, X-Ray Computed*

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