Pitfalls in the sonographic diagnosis of juxtadiaphragmatic pulmonary sequestrations.
BACKGROUND
Sonographic evaluation of juxtadiaphragmatic lesions is frequently the initial imaging modality of choice in the pediatric population. The increasing sophistication of sonographic and Doppler technologies has led to the suggestion in the literature that lesions suspected of being juxtadiaphragmatic pulmonary sequestrations can be confidently imaged by ultrasound examination alone.


OBJECTIVE
To present four cases which raise concern over the accuracy of sonographic examination of these lesions.


METHODS
We present four such lesions for which an initial erroneous diagnosis of pulmonary sequestration was suggested on an initial ultrasound examination.


CONCLUSIONS
The potential of a missed diagnosis of neuroblastoma has led us to propose that any lesion not demonstrating unequivocal sonographic findings of pulmonary sequestration should undergo further investigation and, if necessary, tissue sampling or excision.
Manson
D E
DE
Department of Diagnostic Imaging, Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada. david.manson@sickkids.on.ca
Daneman
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D000236:Adenoma / Q000150:complications / Q000000981:diagnostic imaging; D000310:Adrenal Gland Neoplasms / Q000150:complications / Q000000981:diagnostic imaging; D001998:Bronchopulmonary Sequestration / Q000000981:diagnostic imaging* / Q000209:etiology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009181:Mycoses / Q000150:complications / Q000000981:diagnostic imaging; D009447:Neuroblastoma / Q000150:complications / Q000000981:diagnostic imaging; D013899:Thoracic Neoplasms / Q000150:complications / Q000000981:diagnostic imaging; D018608:Ultrasonography, Doppler; D016216:Ultrasonography, Prenatal