The development of bronchiectasis on chest computed tomography in children with cystic fibrosis: can pre-stages be identified?
Eur Radiol
; 26(12): 4563-4569, 2016 Dec.
Article
em En
| MEDLINE
| ID: mdl-27108295
ABSTRACT
OBJECTIVE:
Bronchiectasis is an important component of cystic fibrosis (CF) lung disease but little is known about its development. We aimed to study the development of bronchiectasis and identify determinants for rapid progression of bronchiectasis on chest CT.METHODS:
Forty-three patients with CF with at least four consecutive biennial volumetric CTs were included. Areas with bronchiectasis on the most recent CT were marked as regions of interest (ROIs). These ROIs were generated on all preceding CTs using deformable image registration. Observers indicated whether bronchiectasis, mucus plugging, airway wall thickening, atelectasis/consolidation or normal airways were present in the ROIs.RESULTS:
We identified 362 ROIs on the most recent CT. In 187 (51.7 %) ROIs bronchiectasis was present on all preceding CTs, while 175 ROIs showed development of bronchiectasis. In 139/175 (79.4 %) no pre-stages of bronchiectasis were identified. In 36/175 (20.6 %) bronchiectatic airways the following pre-stages were identified mucus plugging (17.7 %), airway wall thickening (1.7 %) or atelectasis/consolidation (1.1 %). Pancreatic insufficiency was more prevalent in the rapid progressors compared to the slow progressors (p = 0.05).CONCLUSION:
Most bronchiectatic airways developed within 2 years without visible pre-stages, underlining the treacherous nature of CF lung disease. Mucus plugging was the most frequent pre-stage. KEY POINTS ⢠Development of bronchiectasis in cystic fibrosis lung disease on CT. ⢠Most bronchiectatic airways developed within 2 years without pre-stages. ⢠The most frequently identified pre-stage was mucus plugging. ⢠This study underlines the treacherous nature of CF lung disease.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Bronquiectasia
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Tomografia Computadorizada por Raios X
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Fibrose Cística
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Pulmão
Tipo de estudo:
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adolescent
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Adult
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Child
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Female
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Humans
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Male
Idioma:
En
Revista:
Eur Radiol
Assunto da revista:
RADIOLOGIA
Ano de publicação:
2016
Tipo de documento:
Article
País de afiliação:
Holanda