4.6 Article

High-resolution computed tomography in young patients with cystic fibrosis: Distribution of abnormalities and correlation with pulmonary function tests

Journal

JOURNAL OF PEDIATRICS
Volume 145, Issue 1, Pages 32-38

Publisher

MOSBY-ELSEVIER
DOI: 10.1016/j.jpeds.2004.02.038

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Objective To assess pulmonary abnormalities detected by high-resolution computed tomography (HRCT) in voting children with cystic fibrosis (CF) and mild to moderate lung disease. Study design High-resolution computed tomography was performed in 60 children, 6 to 10 years old, with mild to moderate lung disease (forced expiratory volume in 1 minute [FEV1], 52-137; mean, 102; SD, 15% predicted). HRCTs were scored by using a system that evaluates each lobe for severity and extent of CF lung disease. Findings of CF lung disease were tabulated in all subjects and in a subgroup with normal pulmonary function tests. HRCT scores were correlated with FEV1, forced vital capacity (FVC), and forced expiratory flow between 25% and 75% of expired vital capacity (FEF25-75) ill 57 patients. Results Bronchiectasis was present in 35% of subjects, mucous plugging in 15%, and air trapping in 63%. No abnormality was detected in 2.5%. In 37 subjects with FEV1, FVC, and FEF25-75 >85% predicted, bronchiectasis was present in 30%. In 17% of these subjects, bronchiectasis was seen in greater than or equal to4 lobes. Correlations between HRCT scores and FEV1 were significant and showed fair to moderate correlation (r = 0.36-0.46). Conclusions High-resolution computed tomography demonstrated a broad range of pulmonary abnormalities in young patients with CF with mild to moderate lung disease. In this study, abnormalities, including bronchiectasis, were common in young children with CF and normal pulmonary function tests.

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