Extralobar pulmonary sequestration in neonates: The natural course and predictive factors associated with spontaneous regression
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To describe the natural course of extralobar pulmonary sequestration (EPS) and identify factors associated with spontaneous regression of EPS.
Materials and methods
We retrospectively searched for patients diagnosed with EPS on initial contrast CT scan within 1 month after birth and had a follow-up CT scan without treatment. Spontaneous regression of EPS was assessed by percentage decrease in volume (PDV) and percentage decrease in sum of the diameter of systemic feeding arteries (PDD) by comparing initial and follow-up CT scans. Clinical and CT features were analysed to determine factors associated with PDV and PDD rates.
Fifty-one neonates were included. The cumulative proportions of patients reaching PDV > 50 % and PDD > 50 % were 93.0 % and 73.3 % at 4 years, respectively. Tissue attenuation was significantly associated with PDV rate (B = −21.78, P < .001). The tissue attenuation (B = −22.62, P = .001) and diameter of the largest systemic feeding arteries (B = −48.31, P = .011) were significant factors associated with PDD rate.
The volume and diameter of systemic feeding arteries of EPS spontaneously decreased within 4 years without treatment. EPSs showing a low tissue attenuation and small diameter of the largest systemic feeding arteries on initial contrast-enhanced CT scans were likely to regress spontaneously.
• Extralobar pulmonary sequestration (EPS) could show spontaneous regression.
• Initial CT features may predict spontaneous regression of EPS.
• The tissue attenuation and diameter of systemic feeding artery are important factors.
KeywordsExtralobar pulmonary sequestration Natural course Spontaneous regression Neonate Computed tomography
Extralobar pulmonary sequestration
Percentage decrease in the sum of the diameters of all of the systemic feeding arteries
Percentage decrease in volume
Region of interest
Systemic feeding arteries
The scientific guarantor of this publication is Jin Seong Lee. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. One of the authors (Seon Ok Kim) has significant statistical expertise. Institutional Review Board approval was obtained. Written informed consent was waived by the Institutional Review Board. Methodology: retrospective, observational, performed at one institution.
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