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Radiology

Congenital Pulmonary Airway Malformation

Built from Obstetric Imaging

The first 25 slides of Congenital Pulmonary Airway Malformation
The first 25 slides, exactly as they appear. The full deck has 72 content slides.

What’s inside

10 sections · 72 slides

  1. 01

    Overview

    • The road ahead

    1 slide

  2. 02

    What this lesion is

    Start with the plain idea, then the formal words

    • A patch of lung that never finished building
    • The formal definition
    • How the malformation forms
    • Two names for one condition
    • Who it affects
    • 50-75%

    6 slides

  3. 03

    How common it is

    Why prenatal and postnatal counts do not match

    • The commonest bright lung lesion in the fetus
    • Why the counts disagree

    2 slides

  4. 04

    How it is classified

    One system from the microscope, one from the scan

    • Why bother with types at all
    • Stocker's five types
    • Type I in detail
    • Type II in detail
    • Type III in detail
    • What the types tell you about where it started
    • The two rare extra types
    • The classification you actually use on the scan
    • The split that changes management
    • Two systems side by side

    10 slides

  5. 05

    What you see and what it does

    Appearance on the scan, natural course, and the harm a big mass causes

    • How it appears on the scan
    • Large macrocystic lesion in the left lung
    • What to notice in that image
    • How it behaves over the pregnancy
    • Mostly solid mass with two medium cysts
    • Uniformly bright solid mass filling the left chest
    • What a large mass does to the fetus
    • From growing mass to hydrops
    • Chromosomes and other birth defects

    9 slides

  6. 06

    Predicting the outcome

    Size, lung reserve, and a simple ratio

    • What decides the prognosis
    • Measuring the mass: the CPAM volume ratio
    • > 1.6
    • How to use the CVR in the clinic

    4 slides

  7. 07

    Imaging the lesion

    What ultrasound must answer, and where MRI fits

    • What the ultrasound must answer
    • How each type looks on the screen
    • Blood supply: the deciding feature
    • Solid-cystic mass fed by an artery from the aorta
    • Tracing the feeding vessel
    • The rest of the workup
    • Early warning signs of heart strain
    • How often to rescan
    • Where magnetic resonance imaging fits
    • Bright cystic lesions of the right lung on fetal MRI
    • The transverse view up close
    • Classic signs

    12 slides

  8. 08

    What else it could be

    Four lesions that mimic CPAM on the fetal scan

    • Intralobar bronchopulmonary sequestration
    • Congenital lobar emphysema
    • Bronchial atresia and bronchogenic cyst
    • Congenital diaphragmatic hernia
    • The look-alikes at a glance

    5 slides

  9. 09

    Treatment before birth

    Who needs nothing, who needs a drain, and what is still experimental

    • Most cases need nothing at all
    • Who might need treatment in the womb
    • The grey zone: high risk but no hydrops yet
    • The spectrum of fetal interventions
    • Open fetal surgery
    • Thoracoamniotic shunt: first choice for big cysts
    • What the shunt achieves
    • Which treatment for which lesion
    • Hydrops diagnosed after 34 weeks
    • Microcystic lesions: what can be tried
    • What parents must be told
    • Steroids: the medical option
    • Why steroids come first

    13 slides

  10. 10

    After birth, and the take-home

    Surgery is the rule, and what the referring clinician needs

    • Surgery after birth
    • What the referring clinician needs to know
    • Key points
    • Key points
    • References
    • References (continued)
    • References (continued)
    • References (continued)
    • Suggested readings
    • Obstetric Imaging: Fetal Diagnosis and Care, 2nd Edition

    10 slides