Pitfalls in the sonographic diagnosis of juxtadiaphragmatic pulmonary sequestrations.

BACKGROUND: Sonographic evaluation of juxtadiaphragmatic lesions is frequently the initial imaging modality of choice in the pediatric population. The increasing sophistication of sonographic and Doppler technologies has led to the suggestion in the literature that lesions suspected of being juxtadiaphragmatic pulmonary sequestrations can be confidently imaged by ultrasound examination alone.

OBJECTIVE: To present four cases which raise concern over the accuracy of sonographic examination of these lesions.

MATERIALS AND METHODS: We present four such lesions for which an initial erroneous diagnosis of pulmonary sequestration was suggested on an initial ultrasound examination.

CONCLUSION: The potential of a missed diagnosis of neuroblastoma has led us to propose that any lesion not demonstrating unequivocal sonographic findings of pulmonary sequestration should undergo further investigation and, if necessary, tissue sampling or excision.