Terms in this set (22)
caused by a decrease in number of lung cells, airways, and alveoli, resulting in decreased lung size and weight. end result is small, underdeveloped lungs which prevent the baby from being able to take in enough oxygen. anything that causes oligohydramnios is associated with this. anything that prevents the fetus from inhaling fluid will result in this. lung masses take space in thorax, so they compress lung tissue and result in this. 80% of infants born due soon after birth.
unilateral pulmonary agenesis
rare anomaly; associated with other fetal anomalies. should be considered anytime there is a mediastinal shift and apparent chest mass. presence of esophageal anomalies should increase suspicious for this as well. small percentage have this as an isolated finding in absence of other fetal anomaly or uterine problem. results in shift of heart to far left or right side of chest
80% infants born with this die after birth. sonographic: thoracic measurements- measure chest circumference. below 5% percentile indicative of this. measure lung/estimate lung volume. look for small echogenic lungs lateral to heart. doppler of pulmonary arteries/pulmonary vasculature. observation of fetal breathing
cystic lung mass
anechoic masses that replace normal lung parenchyma. range from small to quite large. may cause shift of thoracic structures. may compress adjacent structures. may be isolated or multiple.
most common prenatally detected cyst. abnormal bud from foregut. no communication with trachea/bronchial tree. usually found with mediastium/lung; rarely inferior to the diaphragm. sonographic findings: small mass with good borders, no mediastinal shift or evidence of heart failure, normal amniotic fluid volume.
pleural effusion (hydrothorax)
fluid accumulation between parietal and visceral layers of pleura. prevents full expansion of lung. may cause pulmonary hypoplasia. may be unilateral or bilateral. may cause mediastinal shift, compression of heart, and/or inversion of diaphragm. causes: chylothorax (located on rt side due to malformation of thoracic duct), hydrops, lymphangiectasia, other malformations of the thorax, chromosomal anomalies, cardiac mass.
sonographic appearance: anechoic fluid collection on one or both sides of the heart that conform to the shape of the thoracic cavity. surrounds the lung tissue; often compresses it. shape of lung appears normal. look for abnormalities of lung, heart, and other signs of hydrops. rarely seen before 15 weeks. prognosis: mortality rate approx 50%, large may cause hypo plastic lungs, some fetal interventions available but risky.
spectrum of abnormalities that are result of abnormal formation of lung tissue/bronchial tree and/or abnormal arterial supply to part o the lung. results in lung masses that replace single lobe of a lung or entire lung. three types: congenital cystic adenomatoid malformation, bronchopulmonary sequestration, mixed lesion containing characteristics of both CCAM and sequestration
part of pulmonary dysplasia. supernumerary (extra) lobe of lung tissue separated from bronchial tree. nonfunctional, does not typically contain cysts, separate blood supply, usually unilateral, most often located in left lower posterior thorax, associated with diaphragmatic hernia, when diagnosed prenatally sometimes decreases in size, bilateral sequestrations indicate laryngeal atresia
type of pulmonary sequestration. extra lung tissue located within the pleural sac. may be found on either side but left is more common. never inferior to diaphragm. spherical in shape. use color do demonstrate blood supply separate from pulmonary tree in order to differentiation. usually good prognosis. echogenic lesion, color flow. can have hydrops, hyoplasitc lung, diaphragmatic hernia, GI anomalies
type of pulmonary sequestration. extra lung tissue has its own pleural sac and is connected to inferior lung. almost always on the left side. rarely inferior to diaphragm. cone/triangular shape. prognosis poor due to associated anomalies/hydrops. echogenic lesion, has blood supply. associated findings are hydrops, hypo plastic lung, diaphragmatic hernia, GI anomalies
congenital cystic adenomatoid malformation (CCAM)
multicystic mass within lung made up of primitive lung tissue and abnormal bronchial structures. caused by genetic alteration in the lung during the first 8-9 weeks of gestation. may involve single lobe to entire lung. rarely bilateral. may communicate with bronchial tree. occurs equally right or left. cysts may be large/small, so appearance varies from complex cystic mass to echogenic solid appearance. may have shift of mediastinum. may have polyhydramnios.
type 1 (macrocystic)
type of CCAM. one/more large cysts replace normal lung tissue. cysts measure 2-10 cm. good prognosis
type 2 (macrocystic with microcystic component)
type of CCAM. multiple small cysts measuring <1 cm. associated with chromosomal anomalies 25% of the time. poor prognosis
type 3 (microcystic)
type of CCAM. many small cysts that are too small to see --> echogenic solid appearance. looks similar to bronchopulmonary sequestration. poor prognosis
congenital bronchial atresia
rare. caused by focal destruction of a segment of the bronchial passage. occurs most often in upper lobe of the left lung. considered pulmonary dysplasia since analogous to type III CCAM involving entire lung. lung will be distended distal to the atresia due to trapped lung secretions. sonographic: echogenic lesion within the lung, normally the bronchi are not visualized sonographically
congenital lobar emphysema
overinflation of lung without destruction of alveolar separations. occurs in super or middle lobe of left lung. presents are large solid mass on sonography much like microcytic CCAM.
congenital laryngeal atresia
rarely found in the fetus. tiny air spaces within lungs are filled with fluid. sonographic findings: bilaterally large lungs with inferior displacement of diaphragm. anterior displacement/compression of the heart, ascites, may have polyhydramnios due to compression of esophagus, may be oligohydramnios due to inability of fluid made by lungs to reach amniotic cavity.
congenital diaphragmatic hernia
herniation of abdominal organs into thoracic cavity through hole in diaphragm. most commonly located on the left side because the left pleuroperitoneal membrane closes later than the right. 90% occur through foramen of bochdalek. greatest source of mortality is the compression of lung tissue and displacement of heart by the herniated abdominal organs. more than 50% have other structural or chromosomal anomalies
left sided hernia
sonographic finding of type of diaphragmatic hernia. heart displaced to the right. stomach seen in chest. spleen, small bowel, colon often in chest but harder to see. small/compressed lung. may see liver in chest which is a poor prognosis.
right sided hernia
sonographic finding of type of diaphragmatic hernia. heart pushed against left chest wall-most common finding. liver seen in right chest. may see gallbladder in chest mimicking lung cyst. stomach inferior to diaphragm, but displaced to right. may see some ascites around liver.
sonographic finding of diaphragmatic hernia type. heterogeneous mass anterior midline in the chest. heart displaced posteriorly and to one side.