Imaging recommendation · Chest

Suspected congenital pulmonary airway malformation (CPAM/CCAM)

Q: What's the alternative imaging for suspected congenital pulmonary airway malformation (cpam/ccam) when postnatal definitive imaging?

CT — CT Chest with IV contrast (iv contrast).

Recommended: Prenatal US + Fetal MRI; postnatal CT Chest is the preferred imaging study for suspected congenital pulmonary airway malformation (cpam/ccam). Cystic / solid lung lesion in neonate.

Recommended study

Prenatal US + Fetal MRI; postnatal CT Chest

MRI No contrast Preferred Chest Outpatient Reviewed 2026-05

Cystic / solid lung lesion in neonate. Stocker classification I-V. Increased risk of infection and rare malignancy (rhabdomyosarcoma).

If the default doesn't apply

Postnatal definitive imaging

CT CT Chest with IV contrast IV contrast

Watch-outs

Differentiate from sequestration

Sequestration has systemic arterial supply; image vessels carefully. Hybrid lesions exist.

Surgical resection consideration

Most asymptomatic CPAMs are resected (typically 6-12 months) due to infection / malignancy risk.

Pearls

Type I (large cysts) most common.
Type III (microcystic / solid) most severe — fetal hydrops risk.
Differentiate from congenital diaphragmatic hernia by abdominal contents in chest.