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Lung CT imaging in patients with bronchopulmonary dysplasia: A systematic review
Esther van Mastrigt1, Karla Logie1,2, Pierluigi Ciet1,3
1Division of Respiratory Medicine, Department of Pediatrics, Erasmus MC-Sophia Children's Hospital, University Medical Centre, Rotterdam, The Netherlands.
Insights
Chest CT scans reveal lung abnormalities in over 85% of infants with bronchopulmonary dysplasia (BPD). Current scoring methods lack validation, highlighting the need for a universal quantitative approach for BPD assessment.
Area of Science:
- Pulmonary Medicine
- Radiology
- Neonatology
Background:
- Bronchopulmonary dysplasia (BPD) is a frequent respiratory issue in premature infants, often leading to lasting respiratory problems.
- Chest computed tomography (CT) is crucial for identifying lung structure changes and predicting future symptoms in BPD patients.
Purpose of the Study:
- To survey chest CT scoring techniques used for evaluating BPD patients.
- To identify structural lung abnormalities in pediatric and adult BPD cases and their association with clinical outcomes.
Main Methods:
- A comprehensive literature search was performed for studies on chest CT imaging in preterm infants with BPD.
Main Results:
- Sixteen articles and three abstracts were selected from 316 original papers.
- Nine semi-quantitative scoring methods were identified, with chest CT revealing abnormalities in over 85% of BPD patients.
- Common abnormalities include reduced pulmonary attenuation, opacities, bronchial wall thickening, and consolidations, some correlating negatively with lung function and respiratory symptoms.
Conclusions:
- Existing chest CT scoring systems for BPD are not adequately validated and show no superiority over one another.
- Further research is required to develop a validated, universal quantitative chest CT scoring method for BPD.
Background:
Bronchopulmonary dysplasia (BPD) is a common respiratory complication of preterm birth and associated with long-term respiratory sequelae. Chest computed tomography (CT) is a sensitive tool to obtain insight in structural lung abnormalities and may be a predictor for later symptoms.
Objectives:
To give an overview of chest CT scoring methods that are used to evaluate chest CT scans of BPD patients. To review which structural lung abnormalities are described in children and adults with BPD and whether these are related to clinical outcomes.
Methods:
An extensive literature search was conducted for relevant studies on chest CT imaging in patients born preterm with BPD.
Results:
We retrieved 316 original papers of which 16 articles and three abstracts fulfilled our inclusion criteria. Overall, we identified nine different semi-quantitative scoring methods. Chest CT scans revealed structural abnormalities in >85% of BPD patients. These abnormalities are decreased pulmonary attenuation, opacities, bronchial wall thickening, and consolidations. Some have been found to be negatively correlated with lung function and respiratory symptoms.
Conclusions:
None of the currently described scoring systems are appropriately validated or superior over another. Future studies are needed to generate a validated and universal chest CT quantitative scoring method for patients with BPD. Pediatr Pulmonol. 2016; 51:975-986. © 2016 Wiley Periodicals, Inc.
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