Dr Arun Gupta Director imaging

Dr Rakhee gupta Dr Vinayak Mittal

Dr Ragini Dr Kiran

Dr Ritesh Mahajan FETAL PULMONARY

SEQUESTRATION.

ADVANCED USG LOUNGE

PYULMONARY SEQUESTRATION.

A pulmonary sequestration (also known as a  Broncho-pulmonary sequestration or cystic lung lesion), is a medical condition wherein a piece of tissue that ultimately develops into lung tissue is not attached to the pulmonary arterial blood supply, as is the case in normally developing lung. As a result, this sequestered tissue is not connected to the normal  bronchial airway architecture, and as a result, fails to function in, and contribute to respiration of the organism.This condition is usually diagnosed in children and is generally thought to be congenital in nature. More and more, these lesions are diagnosed in utero  by prenatal ultrasound .

BPS is estimated to comprise 0.15 to 6.4 percent of all  congenital pulmonary malformations making it an extremely rare disorder.Sequestrations are classified anatomically :

Intra-lobar sequestration (ILS) in which the lesion is located within a normal lobe  and lacks its own  visceral pleura.Extra-lobar sequestration (ELS) in which the mass is located outside the normal lung and has its own visceral pleura.

The blood supply of 75% of pulmonary sequestrations is derived from the thoracic or  abdominal aorta .The remaining 25% of sequestrations receive their blood flow from the subclavian , intercostals ,pulmonary ,pericardio-phrenic,innominate, internal mammary ,celiac , splenic , renal arteries .

PYULMONARY SEQUESTRATION.

DEFINED WEDGE SHAPEDHYPERECHOIC REGION IS APPRECIATED IN LEFT LOWER

LOBE ( BASAL ASPECT ) OF THE FETAL LUNG .

MULTIPLANARIMAGE CORELATION

FOR FOCAL WEDGE SHAPED

HYPERECHOIC AREA

IN THE BASAL ASPECT OF THE

LEFT LOWER LOBE.

Prominent vessel emanating from the abdominal aorta ( subphrenic region) and reaching to the focal echogenic area in the basal aspect of the left lower lobe .

Power doppler also has e/o Branch of ABDOMINAL AORTA

Supplying the hyperechoic focus in the basal aspect of the left lung ) .

DIAGNOSTICULTRASOUNDFOURTH EDITIONCarol M. Rumack, MD, FACRStephanie R. Wilson, MD, FRCPCJ. William Charboneau, MD, FACRRochester, Minnesota

REFERENCE