Intralobar Pulmonary Sequestration in a 46-Year-Old Woman
Findings From Multidetector-Row Computed Tomography and Magnetic Resonance Imaging
A 46-year-old woman with a history of pulmonary infection was referred to our department for imaging. The past medical history included several hospitalizations for fever and radiographic evidence of pulmonary consolidation in the left lower lobe (Figure 1A and 1B). Despite antibiotic treatment, the pulmonary opacity had not completely resolved. Fever, cough, and dizziness were also recurrent. A noninflammatory pulmonary lesion was suspected. Contrast-enhanced (CE) multidetector-row computed tomography (MDCT) and magnetic resonance (MR) imaging were performed (Figures 2 through 5⇓⇓⇓). Both imaging modalities confirmed a nonexcavated pulmonary mass in the posterior basal segment of the left lower lobe. Three-dimensional (3D) reconstructions obtained from CE-MDCT and CE-MR images depicted a systemic arterial supply to the lesion. The aberrant artery originated from the thoracic descending aorta, 4 cm upper to the left crus of the diaphragm. A venous vessel draining from the lesion into the left lower pulmonary vein was shown.
These findings are diagnostic of intralobar pulmonary sequestration, a congenital malformation characterized by anomalous lung tissue, typically localized in the left lower lobe, receiving blood supply by systemic circulation.1–4 CE-MDCT and CE-MR images with multiplanar and 3D reconstructions improve the definition of the arterial and venous vasculature of the malformation, without the need for further invasive diagnostic procedures.