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CT findings and temporal course of persistent pulmonary interstitial emphysema in neonates: a multiinstitutional study.

Publication ,  Journal Article
Donnelly, LF; Lucaya, J; Ozelame, V; Frush, DP; Strouse, PJ; Sumner, TE; Paltiel, HJ
Published in: AJR Am J Roentgenol
April 2003

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.

Duke Scholars

Published In

AJR Am J Roentgenol

DOI

ISSN

0361-803X

Publication Date

April 2003

Volume

180

Issue

4

Start / End Page

1129 / 1133

Location

United States

Related Subject Headings

  • Tomography, X-Ray Computed
  • Sensitivity and Specificity
  • Respiration, Artificial
  • Pulmonary Emphysema
  • Postoperative Complications
  • Outcome and Process Assessment, Health Care
  • Nuclear Medicine & Medical Imaging
  • Male
  • Lung, Hyperlucent
  • Infant, Premature, Diseases
 

Citation

APA
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ICMJE
MLA
NLM
Donnelly, L. F., Lucaya, J., Ozelame, V., Frush, D. P., Strouse, P. J., Sumner, T. E., & Paltiel, H. J. (2003). CT findings and temporal course of persistent pulmonary interstitial emphysema in neonates: a multiinstitutional study. AJR Am J Roentgenol, 180(4), 1129–1133. https://doi.org/10.2214/ajr.180.4.1801129
Donnelly, Lane F., Javier Lucaya, Vanildo Ozelame, Donald P. Frush, Peter J. Strouse, Thomas E. Sumner, and Harriet J. Paltiel. “CT findings and temporal course of persistent pulmonary interstitial emphysema in neonates: a multiinstitutional study.AJR Am J Roentgenol 180, no. 4 (April 2003): 1129–33. https://doi.org/10.2214/ajr.180.4.1801129.
Donnelly LF, Lucaya J, Ozelame V, Frush DP, Strouse PJ, Sumner TE, et al. CT findings and temporal course of persistent pulmonary interstitial emphysema in neonates: a multiinstitutional study. AJR Am J Roentgenol. 2003 Apr;180(4):1129–33.
Donnelly, Lane F., et al. “CT findings and temporal course of persistent pulmonary interstitial emphysema in neonates: a multiinstitutional study.AJR Am J Roentgenol, vol. 180, no. 4, Apr. 2003, pp. 1129–33. Pubmed, doi:10.2214/ajr.180.4.1801129.
Donnelly LF, Lucaya J, Ozelame V, Frush DP, Strouse PJ, Sumner TE, Paltiel HJ. CT findings and temporal course of persistent pulmonary interstitial emphysema in neonates: a multiinstitutional study. AJR Am J Roentgenol. 2003 Apr;180(4):1129–1133.

Published In

AJR Am J Roentgenol

DOI

ISSN

0361-803X

Publication Date

April 2003

Volume

180

Issue

4

Start / End Page

1129 / 1133

Location

United States

Related Subject Headings

  • Tomography, X-Ray Computed
  • Sensitivity and Specificity
  • Respiration, Artificial
  • Pulmonary Emphysema
  • Postoperative Complications
  • Outcome and Process Assessment, Health Care
  • Nuclear Medicine & Medical Imaging
  • Male
  • Lung, Hyperlucent
  • Infant, Premature, Diseases