ABSTRACT Aim To identify congenital pulmonary airway malformation (CPAM) volume ratio (CVR) values that can predict the need for early neonatal surgery. Methods We retrospectively reviewed 70 infants diagnosed with congenital cystic lung diseases (CCLD) over the past 10 years at our center (10 with CPAM, 25 with intra‐ and extra‐lobar bronchopulmonary sequestrations, and 35 with bronchial atresia). Perinatal features, the maximum CVR during pregnancy, and the final CVR before delivery were compared between the early surgery group (surgery within 1 week of birth) and the follow‐up group (surgery after 1 week of birth or no surgery). Results Among all fetuses with CCLD, the median maximum and final CVR values were 1.2 (interquartile range IQR: 0.7–1.9) and 0.5 (IQR: 0.2–0.9) with a median gestational age of 26 weeks (IQR: 24–30) and 34 weeks (IQR: 32–37), respectively. Early neonatal surgery was required in nine infants (five with CPAM, one with bronchopulmonary sequestrations, and three with bronchial atresia). Compared to the follow‐up groups, patients in the early surgery group had higher maximum CVR, higher final CVR, and a greater incidence of polyhydramnios. The maximum and final CVR thresholds of 1.86 and 0.9, yielded sensitivity of 78% and 78% and specificity of 80% and 85%, respectively. The areas under the curve for the maximum and final CVR values were 0.85 and 0.88, respectively. Conclusion A maximum CVR threshold of 1.86 and a final CVR threshold of 0.9 may be useful indicators for predicting the need for early neonatal surgery.
Yanagisawa et al. (Fri,) studied this question.