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[Thoracic imaging in cystic fibrosis : Radiography]
1Klinik und Poliklinik für Radiologie, Klinikum der Universität München, LMU München, Lindwurmstr. 4, 80337, München, Deutschland. Julia.LeyZaporozhan@med.uni-muenchen.de.
Insights
Annual chest X-rays are recommended for cystic fibrosis (CF) patients to monitor lung changes. This imaging technique aids in assessing disease severity and guiding treatment decisions effectively.
Area of Science:
- Medical Imaging
- Pulmonology
- Pediatric Radiology
Background:
- Cystic Fibrosis (CF) necessitates lifelong monitoring, often starting from birth.
- Imaging plays a crucial role in the routine follow-up of CF patients.
Purpose of the Study:
- To outline the utility of chest X-rays in the routine follow-up of pediatric cystic fibrosis patients.
- To describe the typical radiological findings and scoring systems used in CF.
Main Methods:
- Conventional chest X-ray is the guideline-recommended imaging technique for CF patients of all ages.
- X-rays offer a low radiation dose, require no sedation, and are well-standardized.
- Established scoring systems (Chrispin-Norman, Brasfield, Wisconsin) enable reproducible assessment of disease severity.
Main Results:
- Chest X-rays effectively depict structural changes like air-trapping, bronchiectasis, and consolidations.
- Scoring systems correlate well with pulmonary function and clinical status.
- These findings help in assessing CF disease severity.
Conclusions:
- Annual chest X-rays are recommended for CF patients, with additional imaging for clinical deterioration.
- Computed Tomography (CT) may be considered for further treatment-relevant information.
Clinical Issue:
Patients with cystic fibrosis (CF) require regular follow-up examinations, usually from birth onwards, using imaging techniques.
Methods:
The conventional chest x‑ray examination is the only technique recommended by the guidelines at this age. The examination can be performed at every age and is well standardized. The radiation dose to the patient is small and does not require any sedation.
Radiological Findings And Classification:
The typical structural changes of the bronchi and the lung parenchyma can be depicted. Typical findings are air-trapping, bronchiectasis, peribronchial cuffing, bronchial wall thickening, mucus plugging, nodular opacities, atelectasis and/or consolidations and hilar lymphadenopathy. Different scoring systems have been developed to allow for a relatively easy but reproducible assessment of the severity of the disease. The most important ones for daily clinical practice are the Chrispin-Norman score, Brasfield score, and the Wisconsin score. All of them show a good correlation with pulmonary function parameters and the clinical picture of the patients.
Practical Recommendations:
It is recommended to take an annual X‑ray for patients with CF, and in addition in individual cases with clinical deterioration. Computed tomography (CT) can be performed if relevant information for treatment is expected to gained.
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