title: The clinical value of computer tomographic angiography for the diagnosis and therapeutic planning of patients with pulmonary sequestration.
abstract: OBJECTIVE
  This study was conducted to evaluate the clinical value of computed tomographic (CT) angiography for diagnosis and therapeutic planning in patients with pulmonary sequestration.
  
  
  METHODS
  Forty-three patients with suspected pulmonary sequestration underwent CT angiography before undergoing digital subtraction angiography or surgery. For each patient, CT angiography was used to determine whether the pulmonary sequestration was suitable for coil embolization, surgical resection or conservative treatment. The treatments planned using CT angiography were compared with actual treatment decisions made or treatments administered using digital subtraction angiography or surgery.
  
  
  RESULTS
  Digital subtraction angiography and/or surgery confirmed pulmonary sequestration in 37 patients; six patients had no pulmonary sequestration. The diagnostic performance of CT angiography for pulmonary sequestration in the patient-based evaluation yielded an accuracy of 97.7%, sensitivity of 97.3%, specificity of 100%, positive predictive value (PPV) of 100% and negative predictive value (NPV) of 85.7%. The aberrant systemic artery-based evaluation yielded an accuracy of 98.0%, sensitivity of 97.8%, specificity of 100%, PPV of 100% and NPV of 85.7%. Treatments could be correctly planned using CT angiography with 100% accuracy, sensitivity, specificity, PPV and NPV according to the aneurysm-based evaluation.
  
  
  CONCLUSIONS
  We have obtained promising results with a CT angiography-based protocol, rather than a digital subtraction angiography-based protocol, as the only diagnostic and pretreatment planning tool in patients with pulmonary sequestration. The CT angiography-based selection of treatment strategies seems to be safe and effective in the majority of patients with pulmonary sequestration.
authors.affiliation: Department of Radiology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan Province, China.
authors.forename: Song-Wei
authors.initials: SW
authors.lastname: Yue
authors.forename: Hua
authors.initials: H
authors.lastname: Guo
authors.forename: Yong-Gao
authors.initials: YG
authors.lastname: Zhang
authors.forename: Jian-Bo
authors.initials: JB
authors.lastname: Gao
authors.forename: Xiu-Xian
authors.initials: XX
authors.lastname: Ma
authors.forename: Peng-Xu
authors.initials: PX
authors.lastname: Ding
mesh_terms: D000293:Adolescent; D000328:Adult; D015901:Angiography, Digital Subtraction / Q000379:methods*; D001998:Bronchopulmonary Sequestration / Q000000981:diagnostic imaging* / Q000601:surgery / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D013510:Pulmonary Surgical Procedures / Q000379:methods*; D012680:Sensitivity and Specificity; D025321:Surgery, Computer-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult