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Published on: March 6, 2019
[Pulmonary computed tomography in children with cystic fibrosis in Asturias (Spain)]
S Jiménez Treviño1, M Crespo Hernández, J R Jiménez Fernández-Blanco
1Departamento de Pediatría, Hospital Universitario Central de Asturias, Oviedo, España. santipediatra@wanadoo.es
Insights
Computed tomography (CT) in cystic fibrosis (CF) children reveals early bronchiectasis and mucous plugs, primarily affecting the upper right lung segments. These findings correlate with disease duration but not pulmonary function.
Area of Science:
- Radiology
- Pediatric Pulmonology
- Medical Imaging
Background:
- Computed tomography (CT) enables early detection of cystic fibrosis (CF) related lung changes.
- Limited data exists on early pathological changes and bronchiectasis distribution in pediatric CF patients.
- This study focuses on characterizing early CF lung disease patterns in Asturias.
Purpose of the Study:
- To describe the distribution pattern of early pathological changes in children with cystic fibrosis (CF).
- To identify the most frequent lesions and affected bronchopulmonary segments in pediatric CF patients.
- To correlate CT findings with clinical data and pulmonary function.
Main Methods:
- Retrospective analysis of medical records and CT scans from pediatric CF patients.
- CT scans were scored by two radiologists using Bhalla and Nathanson scores.
- Pathological changes were analyzed and correlated with clinical data and pulmonary function tests.
Main Results:
- Bronchiectasis (78.38%) and mucous plugs (37.84%) were the most frequent lesions identified.
- The most commonly affected bronchopulmonary segments were S1 and S2 in the right lung.
- Significant correlations were observed between Bhalla/Nathanson scores and disease duration, but not pulmonary function tests.
Conclusions:
- Bronchiectasis and mucous plugs are the predominant early lesions in pediatric CF patients in this region.
- The upper right lobe is the initial site of affection, consistent with existing literature.
- CT imaging is valuable for assessing early disease progression and distribution in pediatric CF.
Introduction:
The advent of computed tomography (CT) has allowed the early detection of pathological changes in patients with cystic fibrosis (CF). Description of the early pathological changes and distribution of bronchiectasis in children with CF is limited, because most studies have been performed in older children and adults with well-established lung disease. The aim of this study was to describe the distribution pattern of this disease in Asturius.
Material And Method:
We performed a retrospective study of the medical records and CT scans of patients followed up in our Cystic Fibrosis Unit. CT scans were scored by two radiologists according to Bhalla and Nathanson scores. Pathological changes were analyzed and correlated with clinical data and pulmonary function tests.
Results:
The 41 CT reviewed contained between 10 and 47 slices, with a median of 16. The total number of slices was 758, of which 606 (79.95%) were considered acceptable and 152 were considered unacceptable by the radiologists. The most frequent lesions found were bronchiectasis (78.38%), followed by mucous plugs (37.84%). The most frequently affected bronchopulmonary segments were S1 and S2 in the right lung. Statistically significant correlations were found between Bhalla and Nathanson scores and disease duration. No statistically significant correlations were found between Bhalla and Nathanson scores and pulmonary function tests.
Conclusions:
The most frequent lesions in our environment were bronchiectasis followed by mucous plugs. The upper right lobe was the first to be affected, which correlates with findings in most published studies.
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