PEDIATRICS Vol. 101 No. 5 May 1998, pp. 908-913
Cystic Fibrosis: When Should High-resolution Computed Tomography of the Chest Be Obtained?
Received May 23, 1997; accepted Dec 9, 1997.
,
From the Departments of * Pediatrics and Radiology, Federico
II University, Naples, Italy, and the § Institute of Radiology,
University of Bari, Bari, Italy.
Objective. To provide indications for high-resolution computed tomography (HRCT) of the chest in patients with cystic fibrosis (CF).
Design. We compared the HRCT and conventional chest radiography (CCR) scores and assessed their correlation with clinical scores and pulmonary function tests.
Setting. Department of Pediatrics, Federico II University, Naples, Italy.
Subjects. A total of 30 patients with CF 6.75 to 24 years of age.
Results. CCR scores correlated highly with HRCT
(r = 
0.8) and clinical
(r = 0.5) scores, whereas total HRCT scores
were not related to clinical scores. Of all the specific HRCT findings, only bronchiectasis appeared related significantly to the clinical score (r = 0.6). Most pulmonary function tests
were related to CCR and total HRCT scores, but not to HRCT scoring of
specific changes. Forced vital capacity and CCR scores appeared the
best predictors of the HRCT score (multiple R = 0.58 and 0.79, respectively). In patients with mild lung disease, HRCT
detected bronchiectasis and air trapping in 57% and 71% of the cases,
respectively. In patients with more abnormal chest radiographs,
bronchiectasis and air trapping were demonstrated on HRCT in all cases.
Conclusions. These findings suggest that HRCT of the chest is most useful in the identification of early lung abnormalities in patients with CF with mild respiratory symptoms, whereas for established disease, CCR is still the first-line imaging technique. The advantage of detecting early changes on CT imaging awaits additional confirmation, at least until early therapeutic interventions affecting significantly the final outcome of the disease are demonstrated. In patients with advanced disease, HRCT may be useful in the evaluation of specific lung changes when more aggressive treatment such as chest surgical interventions is indicated. Given the cost of the procedure and the high radiation dosage compared with CCR, a careful assessment of the cost:benefit ratios of HRCT is strongly recommended in CF.
Key words: cystic fibrosis, high-resolution computed tomography, lung disease.
CiteULike 
Connotea 
Del.icio.us 
Digg 
Facebook 
Reddit 
Technorati 
Twitter What's this?
This article has been cited by other articles:
|
|
 |
|
  E. Belmaati, C. Jensen, K. F. Kofoed, M. Iversen, I. Steffensen, and M. B. Nielsen Primary graft dysfunction; possible evaluation by high resolution computed tomography, and suggestions for a scoring system Interactive CardioVascular and Thoracic Surgery, November 1, 2009; 9(5): 859 - 867. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M Loeve, P T. W van Hal, P Robinson, P A de Jong, M H Lequin, W C Hop, T J Williams, G D Nossent, and H A Tiddens The spectrum of structural abnormalities on CT scans from patients with CF with severe advanced lung disease Thorax, October 1, 2009; 64(10): 876 - 882. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. W. Song, W.-J. Koh, K. S. Lee, J. Y. Lee, M. J. Chung, T. S. Kim, and O J. Kwon High-Resolution CT Findings of Mycobacterium avium-intracellulare Complex Pulmonary Disease: Correlation with Pulmonary Function Test Results Am. J. Roentgenol., October 1, 2008; 191(4): W160 - W166. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Santamaria, S. Montella, H. A. W. M. Tiddens, G. Guidi, V. Casotti, M. Maglione, and P. A. de Jong Structural and Functional Lung Disease in Primary Ciliary Dyskinesia Chest, August 1, 2008; 134(2): 351 - 357. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Cademartiri, G. Luccichenti, A. A. Palumbo, E. Maffei, G. Pisi, M. Zompatori, and G. P. Krestin Predictive Value of Chest CT in Patients with Cystic Fibrosis: A Single-Center 10-Year Experience Am. J. Roentgenol., June 1, 2008; 190(6): 1475 - 1480. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P M Gustafsson, P A De Jong, H A W M Tiddens, and A Lindblad Multiple-breath inert gas washout and spirometry versus structural lung disease in cystic fibrosis Thorax, February 1, 2008; 63(2): 129 - 134. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. E. Robinson Computed Tomography Scanning Techniques for the Evaluation of Cystic Fibrosis Lung Disease Proceedings of the ATS, August 1, 2007; 4(4): 310 - 315. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. A. de Jong and H. A. W. M. Tiddens Cystic Fibrosis Specific Computed Tomography Scoring Proceedings of the ATS, August 1, 2007; 4(4): 338 - 342. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. W. J. Terheggen-Lagro, H. G. M. Arets, J. van der Laag, and C. K. van der Ent Radiological and functional changes over 3 years in young children with cystic fibrosis Eur. Respir. J., August 1, 2007; 30(2): 279 - 285. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. D. Davis, L. A. Fordham, A. S. Brody, T. L. Noah, G. Z. Retsch-Bogart, B. F. Qaqish, B. C. Yankaskas, R. C. Johnson, and M. W. Leigh Computed Tomography Reflects Lower Airway Inflammation and Tracks Changes in Early Cystic Fibrosis Am. J. Respir. Crit. Care Med., May 1, 2007; 175(9): 943 - 950. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Z A Aziz, J C Davies, E W Alton, A U Wells, D M Geddes, and D M Hansell Computed tomography and cystic fibrosis: promises and problems Thorax, February 1, 2007; 62(2): 181 - 186. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. P. Judge, J. D. Dodd, J. B. Masterson, and C. G. Gallagher Pulmonary Abnormalities on High-Resolution CT Demonstrate More Rapid Decline Than FEV1 in Adults With Cystic Fibrosis. Chest, November 1, 2006; 130(5): 1424 - 1432. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. M. Aukland, T. Halvorsen, K. R. Fosse, A. K. Daltveit, and K. Rosendahl High-Resolution CT of the Chest in Children and Young Adults Who Were Born Prematurely: Findings in a Population-Based Study Am. J. Roentgenol., October 1, 2006; 187(4): 1012 - 1018. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Santamaria, S. Montella, L. Camera, C. Palumbo, L. Greco, and A. L. Boner Lung structure abnormalities, but normal lung function in pediatric bronchiectasis. Chest, August 1, 2006; 130(2): 480 - 486. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S C Langton Hewer Is limited computed tomography the future for imaging the lungs of children with cystic fibrosis? Arch. Dis. Child., May 1, 2006; 91(5): 377 - 378. [Full Text] [PDF]
|
|
|
|
|
|
S Jimenez, J R Jimenez, M Crespo, E Santamarta, C Bousono, and J Rodriguez Computed tomography in children with cystic fibrosis: a new way to reduce radiation dose Arch. Dis. Child., May 1, 2006; 91(5): 388 - 390. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P A de Jong, A Lindblad, L Rubin, W C J Hop, J C de Jongste, M Brink, and H A W M Tiddens Progression of lung disease on computed tomography and pulmonary function tests in children and adults with cystic fibrosis Thorax, January 1, 2006; 61(1): 80 - 85. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. S. Brody, H. A. W. M. Tiddens, R. G. Castile, H. O. Coxson, P. A. de Jong, J. Goldin, W. Huda, F. R. Long, M. McNitt-Gray, M. Rock, et al. Computed Tomography in the Evaluation of Cystic Fibrosis Lung Disease Am. J. Respir. Crit. Care Med., November 15, 2005; 172(10): 1246 - 1252. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. M. Martinez, C. J. Llapur, T. H. Williams, C. Coates, R. Gunderman, M. D. Cohen, M. S. Howenstine, O. Saba, H. O. Coxson, and R. S. Tepper High-Resolution Computed Tomography Imaging of Airway Disease in Infants with Cystic Fibrosis Am. J. Respir. Crit. Care Med., November 1, 2005; 172(9): 1133 - 1138. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. A. de Jong, Y. Nakano, W. C. Hop, F. R. Long, H. O. Coxson, P. D. Pare, and H. A. Tiddens Changes in Airway Dimensions on Computed Tomography Scans of Children with Cystic Fibrosis Am. J. Respir. Crit. Care Med., July 15, 2005; 172(2): 218 - 224. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. A. de Jong, N. L. Muller, P. D. Pare, and H. O. Coxson Computed tomographic imaging of the airways: relationship to structure and function Eur. Respir. J., July 1, 2005; 26(1): 140 - 152. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. A. de Jong, M. D. Ottink, S. G. F. Robben, M. H. Lequin, W. C. J. Hop, J. J. E. Hendriks, P. D. Pare, and H. A. W. M. Tiddens Pulmonary Disease Assessment in Cystic Fibrosis: Comparison of CT Scoring Systems and Value of Bronchial and Arterial Dimension Measurements Radiology, May 1, 2004; 231(2): 434 - 439. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P.A. de Jong, Y. Nakano, M.H. Lequin, J.R Mayo, R. Woods, P.D. Pare, and H.A.W.M. Tiddens Progressive damage on high resolution computed tomography despite stable lung function in cystic fibrosis Eur. Respir. J., January 1, 2004; 23(1): 93 - 97. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. L. Gibson, J. L. Burns, and B. W. Ramsey Pathophysiology and Management of Pulmonary Infections in Cystic Fibrosis Am. J. Respir. Crit. Care Med., October 15, 2003; 168(8): 918 - 951. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. S. Brody Cystic Fibrosis: When Should High-resolution Computed Tomography of the Chest Be Obtained? Pediatrics, June 1, 1998; 101(6): 1071 - 1071. [Full Text]
|
|
