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Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus
Published on: March 6, 2019
[High resolution computed tomographic findings in infants with diffuse lung disease]
Xinyu Yuan1, Yang Yang, Jinghui Mou
1Radiology Department, Children Hospital Affiliated to the Capital Institute of Pediatrics, Beijing 100020, China.
Insights
High-resolution computed tomography (HRCT) reveals distinct features in infants with diffuse lung disease (DLD). These HRCT findings aid clinicians in accurately diagnosing infantile DLD based on its underlying cause.
Area of Science:
- Pediatric Radiology
- Pulmonology
- Medical Imaging
Background:
- Infantile diffuse lung disease (DLD) presents diagnostic challenges.
- Accurate diagnosis is crucial for effective management of DLD in infants.
Purpose of the Study:
- To investigate high-resolution computed tomographic (HRCT) features of infantile DLD.
- To improve the clinical diagnostic accuracy of infantile DLD using HRCT.
Main Methods:
- Retrospective analysis of HRCT images from 75 infants (under 2 years) with DLD.
- Cases were categorized into systemic diseases-associated, alveolar structure disorders-associated, and infancy-specific DLD.
- HRCT findings including airway, interstitial, and air space disorders were reviewed.
Main Results:
- Significant differences in HRCT signs such as bronchiectasis, thickened bronchiolar wall, mosaic sign, reticular opacity, intralobular nodules, and consolidations were observed across groups.
- Intralobular nodules were characteristic of systemic diseases-associated DLD.
- Bronchiectasis was more frequent in alveolar structural disorders-associated DLD.
Conclusions:
- HRCT features vary significantly among different causes of infantile DLD.
- Specific HRCT findings like intralobular nodules and bronchiectasis can help differentiate DLD subtypes.
- Integrating HRCT findings with clinical data enhances diagnostic accuracy for infantile DLD.
Objective:
To investigate the high-resolution computed tomographic (HRCT) features of infants with diffuse lung disease (DLD) for improving the diagnostic accuracy clinically.
Method:
Totally 75 infants under 2 years of age with DLD (2010-2013) were involved in this study. Among them, 56 were males and 19 females, aged from 2 days to 24 months (mean age was 10.9 months). According to the clinical or pathological data, the cases were enrolled into three groups, including systemic diseases-associated infantile DLD (30 cases), alveolar structure disorders-associated infantile DLD (23 cases), and infantile DLD specific to infancy (22 cases). Retrospectively, HRCT images, from the three groups respectively, were analyzed and compared. HRCT presentations including airway disorders, interstitial disorders and air space disorders were reviewed. Inter-reviewers consistency check was performed, the consistency between reviewers was good (K = 0.64;P = 0.03, < 0.05), as well as χ(2) test.
Result:
Among the three groups, some of the HRCT sings (bronchiectasis, thickened bronchiolar wall, mosaic sign, reticular, intralobular nodules and consolidations) had significant differences (χ(2) = 24.52, 6.08, 18.00, 12.56, 9.11 and 11.50, P < 0.05) .
Conclusion:
The HRCT features of infantile pulmonary DLD/interstitial LD with different causes were as follows, compared to the other two groups, intralobular nodules was the main feature of the systemic diseases-associated infantile DLD, thickened bronchiolar wall, mosaic sign and consolidations were rare as well. Meanwhile, bronchiectasis was more common in alveolar structural disorders-associated infantile DLD, and reticular opacity was rarely seen. Associated clinical data, the HRCT presentations would help clinicians to make accurate diagnosis.
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