{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T03:03:13Z","timestamp":1760151793147,"version":"build-2065373602"},"reference-count":34,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2022,4,12]],"date-time":"2022-04-12T00:00:00Z","timestamp":1649721600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Purpose: To retrospectively compare the lung and pleural findings in children with pulmonary vein stenosis (PVS) with and without aspiration on multidetector computed tomography (MDCT). Materials and Methods: All consecutive children (\u226418 years old) with PVS who underwent thoracic MDCT studies from August 2004 to December 2021 were categorized into two groups: children with PVS with aspiration (Group 1) and children with PVS without aspiration (Group 2). Two independent pediatric radiologists retrospectively evaluated thoracic MDCT studies for the presence of lung and pleural abnormalities as follows: (1) in the lung (ground-glass opacity (GGO), consolidation, nodule, mass, cyst(s), interlobular septal thickening, and fibrosis) and (2) in the pleura (thickening, effusion, and pneumothorax). Interobserver agreement between the two reviewers was evaluated by the proportion of agreement and the Kappa statistic. Results: The final study population consisted of 64 pediatric patients (36 males (56.3%) and 43 females (43.7%); mean age, 1.7 years; range, 1 day\u201317 years). Among these 64 patients, 19 patients (29.7%) comprised Group 1 and the remaining 45 patients (70.3%) comprised Group 2. In Group 1 (children with PVS with aspiration), the detected lung and pleural MDCT abnormalities were: GGO (17\/19; 89.5%), pleural thickening (17\/19; 89.5%), consolidation (16\/19; 84.5%), and septal thickening (16\/19; 84.5%). The lung and pleural MDCT abnormalities observed in Group 2 (children with PVS without aspiration) were: GGO (37\/45; 82.2%), pleural thickening (37\/45; 82.2%), septal thickening (36\/45; 80%), consolidation (3\/45; 6.7%), pleural effusion (1\/45; 2.2%), pneumothorax (1\/45; 2.2%), and cyst(s) (1\/45; 2.2%). Consolidation was significantly more common in pediatric patients with both PVS and aspiration (Group 1) (p &lt; 0.001). There was high interobserver agreement between the two independent reviewers for detecting lung and pleural abnormalities on thoracic MDCT studies (Kappa = 0.98; CI = 0.958, 0.992). Conclusion: Aspiration is common in pediatric patients with PVS who undergo MDCT and was present in nearly 30% of all children with PVS during our study period. Consolidation is not a typical radiologic finding of PVS in children without clinical evidence of aspiration. When consolidation is present on thoracic MDCT studies in pediatric patients with PVS, the additional diagnosis of concomitant aspiration should be considered.<\/jats:p>","DOI":"10.3390\/children9040543","type":"journal-article","created":{"date-parts":[[2022,4,12]],"date-time":"2022-04-12T02:48:59Z","timestamp":1649731739000},"page":"543","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Lung and Pleural Findings of Children with Pulmonary Vein Stenosis with and without Aspiration: MDCT Evaluation"],"prefix":"10.3390","volume":"9","author":[{"given":"Abbey J.","family":"Winant","sequence":"first","affiliation":[{"name":"Department of Radiology, Boston Children\u2019s Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0030-7013","authenticated-orcid":false,"given":"Ryan","family":"Callahan","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Boston Children\u2019s Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara O.","family":"Vargas","sequence":"additional","affiliation":[{"name":"Department of Pathology, Boston Children\u2019s Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8702-988X","authenticated-orcid":false,"given":"Kathy J.","family":"Jenkins","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Boston Children\u2019s Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vanessa","family":"Rameh","sequence":"additional","affiliation":[{"name":"Department of Radiology, Boston Children\u2019s Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick R.","family":"Johnston","sequence":"additional","affiliation":[{"name":"Department of Radiology, Boston Children\u2019s Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8966-5062","authenticated-orcid":false,"given":"Maria","family":"Niccum","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Children\u2019s Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mirjam L.","family":"Keochakian","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Boston Children\u2019s Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edward Y.","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Radiology, Boston Children\u2019s Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,4,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"747812","DOI":"10.3389\/fped.2021.747812","article-title":"Pulmonary vein stenosis: Moving from past pessimism to future optimism","volume":"9","author":"McLennan","year":"2021","journal-title":"Front. Pediatr."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e296","DOI":"10.1542\/neo.22-5-e296","article-title":"Primary pulmonary vein stenosis: A new look at rare but challenging disease","volume":"22","author":"Jadcherla","year":"2022","journal-title":"Neoreviews"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1528","DOI":"10.1038\/s41372-021-01008-7","article-title":"Primary pulmonary vein stenosis during infancy: State of the art review","volume":"41","author":"Frank","year":"2021","journal-title":"J. Perinatol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1007\/s11886-020-01395-x","article-title":"Treatment of congenital and acquired pulmonary vein stenosis","volume":"22","author":"Suntharos","year":"2020","journal-title":"Curr. Cardiol. Rep."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2169","DOI":"10.1016\/j.jtcvs.2020.05.117","article-title":"Pulmonary vein stenosis: Treatment and challenges","volume":"161","author":"Vanderlaan","year":"2021","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1002\/ppul.24848","article-title":"The many faces and outcomes of pulmonary vein stenosis in early childhood","volume":"56","author":"Hump","year":"2021","journal-title":"Pediatr. Pulmonol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/j.carpath.2005.11.006","article-title":"Pulmonary vein stenosis: Expression of receptor tyrosine kinases by lesion cells","volume":"15","author":"Riedlinger","year":"2006","journal-title":"Cardiovasc. Pathol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1016\/S0002-9149(00)01022-5","article-title":"Mechanism of pulmonary vein stenosis in infants with normally connected veins","volume":"86","author":"Sadr","year":"2000","journal-title":"Am. J. Cardiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1111\/j.1747-0803.2012.00647.x","article-title":"Bilateral disease and early age at presentation are associated with shorter survival in patients with congenital heart disease and intraluminal pulmonary vein stenosis","volume":"7","author":"Balasubaramanian","year":"2012","journal-title":"Congenit. Heart Dis."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1029","DOI":"10.1016\/j.jtcvs.2019.08.105","article-title":"Management outcomes of primary pulmonary vein stenosis","volume":"159","author":"Rosenblum","year":"2020","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"911","DOI":"10.1016\/j.jtcvs.2015.06.050","article-title":"Outcomes of surgery for young children with multivessel pulmonary vein stenosis","volume":"150","author":"Quinonez","year":"2015","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.jpeds.2018.01.029","article-title":"Adjunct targeted biologic inhibition agents to treat aggressive multivessel intraluminal pediatric pulmonary vein stenosis","volume":"198","author":"Callahan","year":"2018","journal-title":"J. Pediatr."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1063","DOI":"10.1002\/ppul.23679","article-title":"Pulmonary vein stenosis of ex-premature infants with pulmonary hypertension and bronchopulmonary dysplasia, epidemiology, and survival from a multicenter cohort","volume":"52","author":"Mahgoub","year":"2017","journal-title":"Pediatr. Pulmonol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1053\/j.semtcvs.2018.09.027","article-title":"Pulmonary vein stenosis: Outcomes in children with congenital heart disease and prematurity","volume":"31","author":"DiLorenzo","year":"2019","journal-title":"Semin. Thorac. Cardiovasc. Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1016\/j.jtcvs.2015.08.121","article-title":"Pulmonary vein stenosis: Severity and location predict survival after surgical repair","volume":"151","author":"Gazzaz","year":"2016","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1016\/j.athoracsur.2017.03.022","article-title":"Primary pulmonary vein stenosis: Outcomes, risk factors, and severity score in a multicentric study","volume":"104","author":"Kalfa","year":"2017","journal-title":"Ann. Thorac. Surg."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Niccum, M., Callahan, R., Gauvreau, K., and Jenkins, K.J. (2021). Aspiration is associated with poor treatment response in pediatric pulmonary vein stenosis. Children, 8.","DOI":"10.3390\/children8090783"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"929","DOI":"10.1007\/s00247-013-2647-8","article-title":"Proximal pulmonary vein stenosis detection in pediatric patients: Value of multiplanar and 3D VR imaging evaluation","volume":"43","author":"Lee","year":"2013","journal-title":"Pediatr. Radiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"921","DOI":"10.1016\/j.rcl.2011.06.009","article-title":"Congenital pulmonary malformations in pediatric patients: Review and update on etiology, classification, and imaging findings","volume":"49","author":"Lee","year":"2011","journal-title":"Radiol. Clin. N. Am."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1148\/radiol.2473062124","article-title":"Multidetector CT evaluation of congenital lung anomalies","volume":"247","author":"Lee","year":"2008","journal-title":"Radiology"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1097\/RTI.0000000000000590","article-title":"Thoracic multidetector computed tomography angiography of primary pulmonary vein stenosis in children: Evaluation of characteristic extravascular findings","volume":"36","author":"Lee","year":"2021","journal-title":"J. Thorac. Imaging"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Lee, E.Y., Callahan, R., Vargas, S.O., Jenkins, K.J., Park, H.J., Gauthier, Z., and Winant, A.J. (2021). Extravascular MDCT findings of pulmonary vein stenosis in children with cardiac septal defect. Children, 8.","DOI":"10.3390\/children8080667"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Lee, E.Y., Vargas, S.O., Jenkins, K.J., Callahan, R., Park, H.J., Gauthier, Z., and Winant, A.J. (2021). Secondary pulmonary vein stenosis due to total anomalous pulmonary venous connection repair in children: Extravascular MDCT findings. Children, 8.","DOI":"10.3390\/children8090726"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1148\/radiol.2462070712","article-title":"Fleischner Society: Glossary of terms for thoracic imaging","volume":"3","author":"Hansell","year":"2008","journal-title":"Radiology"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1097\/RCT.0b013e3181ed6450","article-title":"Streptococcus milleri group pleuropulmonary infection in children: Computed tomography findings and clinical features","volume":"43","author":"Lee","year":"2010","journal-title":"J. Comput. Assist. Tomogr."},{"key":"ref_26","unstructured":"SAS Institute Inc. (2015). SAS\/STAT\u00ae 14.1 User Guide, SAS Institute Inc."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Winant, A.J., Vargas, S.O., Jenkins, K.J., Callahan, R., Rameh, V., Krone, K.A., Johnston, P.R., Keochakian, M.L., and Lee, E.Y. (2022). Winant, A.J.; et al. Pleuropulmonary MDCT Findings: Comparison between Children with Pulmonary Vein Stenosis and Prematurity-Related Lung Disease. Children, 9.","DOI":"10.3390\/children9030355"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1542\/pir.2018-0124","article-title":"Dysphagia and chronic pulmonary aspiration in children","volume":"41","author":"Tutor","year":"2020","journal-title":"Pediatr. Rev."},{"key":"ref_29","first-page":"74","article-title":"Chronic pulmonary aspiration in children: Diagnosis and management","volume":"48","year":"2018","journal-title":"Curr. Probl. Pediatr. Adolesc. Health Care"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1183\/09031936.06.00138305","article-title":"Advances in the diagnosis and management of chronic pulmonary aspiration in children","volume":"28","author":"Boesch","year":"2006","journal-title":"Eur. Respir. J."},{"key":"ref_31","unstructured":"Lee, E.Y. (2019). Pediatric Thoracic Imaging, Wolters Kluwer Press."},{"key":"ref_32","unstructured":"Lee, E.Y. (2018). Pediatric Radiology: Practical Imaging Evaluation of Infants and Children, Wolters Kluwer Press."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"219","DOI":"10.2350\/15-07-1670-OA.1","article-title":"Lung pathology in pediatric pulmonary vein stenosis","volume":"30","author":"Pogoriler","year":"2016","journal-title":"Pediatr. Dev. Pathol."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Callahan, R., Gauthier, Z., Toba, S., Sanders, S.P., Porras, D., and Vargas, S.O. (2021). Correlation of intravascular ultrasound with histology in pediatric pulmonary vein stenosis. Children, 8.","DOI":"10.3390\/children8030193"}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/9\/4\/543\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:52:09Z","timestamp":1760136729000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/9\/4\/543"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,12]]},"references-count":34,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2022,4]]}},"alternative-id":["children9040543"],"URL":"https:\/\/doi.org\/10.3390\/children9040543","relation":{},"ISSN":["2227-9067"],"issn-type":[{"type":"electronic","value":"2227-9067"}],"subject":[],"published":{"date-parts":[[2022,4,12]]}}}