BACKGROUND Delineation of the anatomy and integrity of the pulmonary fissures at CT is important because anomalous or incomplete fissures might increase the risk of surgery and of postoperative complications. OBJECTIVE To preoperatively evaluate the integrity of the pleural fissures in children with congenital lung malformations and determine whether anomalous fissural anatomy is a risk factor for a more complicated surgery and postoperative course. MATERIALS AND METHODS We reviewed preoperative multi-detector CT scans of consecutive children who underwent open or thoracoscopic resection of a congenital pulmonary malformation from 2008 to 2018, to determine the integrity of the fissural anatomy, and compared these findings with the surgical report. We correlated postoperative factors including operating room time, days in hospital and chest tube with the operating room documented fissural integrity. RESULTS We saw a significant association between the radiologically determined fissural integrity at CT and the operative findings independently for the right, left and both lungs combined (P<0.001). The sensitivity of CT to determine fissural integrity was 76.9%, specificity 95.2%, positive predictive value 95.2%, negative predictive value 76.9%, and accuracy 85.1%. There was a statistically significant association between size of the pulmonary malformation and the integrity of the fissure(s) (P=0.024). Larger lesions also resulted in a significantly longer hospitalization (P=0.024). CONCLUSION Chest CT showed high accuracy for delineating fissural anatomy in children with congenital pulmonary malformations, with a good interobserver correlation. Incomplete lung fissures were found more often in children with larger congenital pulmonary malformations. In addition, larger lesions were associated with longer hospital stays. Therefore, children with incomplete fissures may have a longer postoperative course. Analysis of the fissural anatomy should be included in the CT report.

中文翻译：

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先天性肺畸形患儿在多探测器计算机断层扫描中的术前肺部解剖结构描述及其对手术并发症和术后病程的影响。

背景技术在CT处确定肺裂的解剖结构和完整性很重要，因为异常或不完全的裂隙可能会增加手术和术后并发症的风险。目的在术前评估先天性肺畸形患儿胸膜裂缝的完整性，并确定异常的解剖结构是否是更复杂的手术和术后过程的危险因素。材料与方法我们回顾了2008年至2018年对连续性先天性肺畸形行开放或胸腔镜切除的儿童的术前多探测器CT扫描，以确定裂隙解剖的完整性，并将这些发现与手术报告进行了比较。我们将术后因素包括手术室时间，在医院和外科手术室的胸管记录有裂隙完整性。结果我们发现，在X线检查中，放射学确定的裂隙完整性与右，左，双肺合并的手术结果之间存在显着相关性（P <0.001）。CT确定裂隙完整性的敏感性为76.9％，特异性为95.2％，阳性预测值为95.2％，阴性预测值为76.9％，准确性为85.1％。肺畸形的大小与裂缝的完整性之间存在统计学上的显着关联（P = 0.024）。较大的病灶也导致住院时间明显延长（P = 0.024）。结论胸部CT对先天性肺畸形患儿的骨裂解剖结构描述具有很高的准确性，并且观察者之间具有良好的相关性。先天性肺畸形较大的患儿更经常发现肺不完整。此外，更大的病变与更长的住院时间有关。因此，裂痕不全的儿童术后病程可能更长。CT报告中应包括对裂隙解剖的分析。