Multidetector CT angiography in pulmonary sequestration.
OBJECTIVE
To evaluate the role of multidetector CT angiography in the diagnosis and preoperative assessment of pulmonary sequestration with angiographic or surgical correlation.


METHODS
Eight patients (5 males, 3 females) in the age range of 2 days to 35 years suspected of having pulmonary sequestration on the basis of clinical history and chest radiographs were included in the study. All patients underwent CT angiography (4 or 16 slice) and MPVR, MIP and 3D volume rendered images were generated. The axial images were also reviewed at soft tissue and lung window settings to evaluate the parenchymal changes.


RESULTS
CT angiography showed five pulmonary sequestrations on the left and three on the right, located in the basal segments (n = 7) or paravertebral region (n = 1). Aberrant systemic arterial supply was demonstrated in all cases: from the descending thoracic aorta (n = 2); abdominal aorta (n = 3) and celiac axis (n = 3). Venous drainage into inferior pulmonary veins was demonstrated in 4 patients. The angioarchitecture depicted on CT angiography was confirmed on surgery in five patients and by DSA in two patients who subsequently underwent embolization using PVA particles and/or coils.


CONCLUSIONS
The ability of CT angiography to simultaneously image the arterial supply, venous drainage and parenchymal changes in a single examination makes it the imaging modality of choice for the diagnosis and preoperative assessment of pulmonary sequestration.
Kang
Mandeep
M
Department of Radiodiagnosis, Postgraduate Institute of Medical Education and Research, Chandigarh, India. mandykang2005@yahoo.com
Khandelwal
Niranjan
N
Ojili
Vijayanadh
V
Rao
Katragadda Lakshmi Narasimha
KL
Rana
Sandip Singh
SS
D000293:Adolescent; D000328:Adult; D000792:Angiography / Q000379:methods*; D001998:Bronchopulmonary Sequestration / Q000000981:diagnostic imaging*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D014057:Tomography, X-Ray Computed