From the Research
Pulmonary sequestration is diagnosed through a combination of imaging studies, with CT angiography being the gold standard, as it clearly demonstrates the abnormal systemic arterial supply to the sequestered lung tissue, which is the hallmark of this condition 1. The diagnosis of pulmonary sequestration typically begins with a chest X-ray, which may show a mass or opacity but is not diagnostic.
- CT angiography is preferred as it provides detailed images of the anomalous systemic arterial supply to the sequestered lung tissue.
- MRI angiography serves as an alternative for patients who cannot undergo CT with contrast.
- Ultrasound is valuable for prenatal diagnosis and in pediatric patients.
- Conventional angiography, while historically important, is now rarely needed due to the availability of non-invasive imaging techniques.
- Bronchoscopy has limited utility as the sequestered segment typically lacks communication with the normal bronchial tree.
- Laboratory tests are not specific but may show signs of infection if the sequestration is complicated. Definitive diagnosis requires demonstration of the anomalous systemic arterial supply, abnormal lung tissue that doesn't communicate with the normal bronchial tree, and venous drainage either to the pulmonary or systemic circulation, as reported in a study published in the Journal of Thoracic Disease 1. Early and accurate diagnosis is essential as pulmonary sequestrations can lead to recurrent infections, hemoptysis, or heart failure due to left-to-right shunting, highlighting the importance of a thorough diagnostic approach, including CT angiography, as supported by a study in the European Journal of Cardio-Thoracic Surgery 2.