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Quantitative CT and pulmonary function in children with post-infectious bronchiolitis obliterans
Jonghyeon Kim1, Myung-Joon Kim1, In Suk Sol2
1Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, South Korea.
Insights
Quantitative CT scans can assess airway and air-trapping in children with post-infectious bronchiolitis obliterans (PIBO). These measurements correlate with pulmonary function, aiding in diagnosis and management.
Area of Science:
- Pediatric Pulmonology
- Radiology
- Medical Imaging
Background:
- Post-infectious bronchiolitis obliterans (PIBO) is a chronic lung disease in children.
- Accurate assessment of airway obstruction and air trapping is crucial for managing PIBO.
Purpose of the Study:
- To evaluate the feasibility of CT-based quantitative airway and air-trapping measurements in pediatric PIBO patients.
- To determine the correlation between these CT-derived parameters and pulmonary function test (PFT) results.
Main Methods:
- Retrospective analysis of chest CT scans and PFTs from 23 children with PIBO.
- Quantitative CT analysis of segmental and subsegmental bronchi (lumen, wall, and total area).
- Measurement of air-trapping volume (ATV) and correlation with PFTs (FEV1, reactance at 5 Hz).
Main Results:
- CT-based airway and air-trapping measurements were feasible in pediatric PIBO patients.
- Increased airway wall area negatively correlated with forced expiratory volume in one second (FEV1).
- Increased air-trapping volume (ATV) negatively correlated with FEV1 and positively correlated with reactance at 5 Hz.
Conclusions:
- CT-based quantitative airway and air-trapping measurements are feasible in children with PIBO.
- These quantitative CT parameters show significant correlation with pulmonary function, offering valuable insights for clinical assessment.
Objective:
To investigate the feasibility of CT-based quantitative airway and air-trapping measurements and to assess their correlation with pulmonary function in children with post-infectious bronchiolitis obliterans (PIBO).
Materials And Methods:
This retrospective study approved by the institutional review board included chest CT scans and pulmonary function tests (PFT) completed between January 2005 and December 2016 in children diagnosed with PIBO. The quantitative analysis of segmental and subsegmental bronchi was performed on each chest CT scan, measuring the areas or diameters of lumens, walls, or the entire airway. The air-trapping volume (ATV), the volume of lung area exhibiting lower attenuation than the mean attenuation of normal and air-trapping areas, was also measured in each lobe. Comparison analyses between CT parameters and PFT results were performed with Pearson or Spearman correlation.
Results:
In total, 23 patients were enrolled (mean age 7.0 ± 3.3 years; range, 4-15 years). We successfully measured 89.6% of all segmental bronchi. In the airway analysis, wall area showed a negative correlation with forced expiratory volume in one second (FEV1) in the majority of the pulmonary lobes. Air-trapping analyses demonstrated that ATV was negatively correlated with FEV1 and positively correlated with reactance at 5 Hz.
Conclusion:
Quantitative airway and air-trapping measurements from chest CT are feasible and correlate with pulmonary function in pediatric PIBO patients.
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