Diagnostic ultrasound ( PDFDrive )

CHAPTER 50 The Pediatric Chest 1715
A
B
FIG. 50.22 Pneumonia Showing Scattered Air Bronchograms. (A) and (B) Transverse and longitudinal sonograms of two patients in a plane
that is not parallel to the long axis of the bronchi show scattered echoes of variable lengths from scattered air bronchograms. Fluid surrounds the
consolidated lung.
A
B
FIG. 50.23 Round Pneumonia. (A) Lateral chest radiograph shows a rounded opacity posteriorly in this 12-year-old child. (B) Transverse
sonogram shows air bronchograms within the lesion, conirming it as round pneumonia, with a small amount of pleural luid surrounding the
consolidated lung. Ultrasound diagnosis helped avoid ionizing radiation from a computed tomography scan.
Congenital Pulmonary Airway
Malformation
Congenital pulmonary airway malformation (CPAM) comprises
a spectrum of disorders that include bronchopulmonary malformation,
hybrid lesions (CPAM and sequestration), and
congenital lobar overinlation.
Bronchopulmonary malformations may contain systemic
and/or pulmonary vascularity and cysts. When only cysts are
present with no systemic vascularity, these were previously called
congenital cystic adenomatoid malformation (CCAM). Type
I has one or more large cysts measuring more than 2 cm in size.
Type II has multiple small cysts, less than 2 cm. Type III has
microcysts but appears solid on ultrasound and on gross
examination. 1
Pulmonary sequestrations may be extralobar or intralobar,
and have systemic vascular supply. 29,30 Extralobar sequestration 31
is congenital and has pulmonary tissue with a separate pleura.
Extralobar sequestration typically manifests in infancy. Intralobar
sequestration is acquired ater recurrent infections causing