Distribution of early structural lung changes due to cystic fibrosis detected with chest computed tomography

Mott, Lauren S., Park, Judy, Gangell, Catherine L., de Klerk, Nicholas H., Sly, Peter D., Murray, Conor P. and Stick, Stephen M. (2013) Distribution of early structural lung changes due to cystic fibrosis detected with chest computed tomography. Journal of Pediatrics, 163 1: 243-248.e3. doi:10.1016/j.jpeds.2012.12.042


Author Mott, Lauren S.
Park, Judy
Gangell, Catherine L.
de Klerk, Nicholas H.
Sly, Peter D.
Murray, Conor P.
Stick, Stephen M.
Title Distribution of early structural lung changes due to cystic fibrosis detected with chest computed tomography
Journal name Journal of Pediatrics   Check publisher's open access policy
ISSN 0022-3476
1097-6833
1085-8695
Publication date 2013-07-01
Year available 2013
Sub-type Article (original research)
DOI 10.1016/j.jpeds.2012.12.042
Open Access Status Not yet assessed
Volume 163
Issue 1
Start page 243
End page 248.e3
Total pages 9
Place of publication Philadelphia, PA United States
Publisher Mosby
Language eng
Subject 2735 Pediatrics, Perinatology, and Child Health
Abstract Objective To examine the distribution of early structural lung changes in clinically stable infants and young children with cystic fibrosis using chest computed tomography (CT).
Formatted abstract
Objective To examine the distribution of early structural lung changes in clinically stable infants and young children with cystic fibrosis using chest computed tomography (CT).

Study design This cross-sectional study included 62 children aged 1-6 years with volume-controlled volumetric chest CT scans performed under general anesthesia as part of an early surveillance program. Each lobe was scored for presence and extent of bronchiectasis, mucus plugging, and air trapping using a semiquantitative score. The topographic distribution of structural abnormalities was evaluated by comparing the presence and extent of abnormalities in different lung regions and examining relationships between components.

Results Although bronchiectasis was most common in the right upper lobe, overall changes in lung structure were not more common or more extensive in the upper lobes. Rather, bronchiectasis was more common in the right lung (right lung 0.95, left lung 0.68, P = .003), and mucus plugging (upper 0.41, middle 0.41, lower 0.72, P = .028) and air trapping (upper 0.79, middle 0.48, lower 0.96, P < .001) were more common in the lower lobes. The extents of bronchiectasis (P < .001) and air trapping (P = .011) were greater in the right lung. Scans with bronchiectasis were also more likely to have coexisting mucus plugging (P = .008) and air trapping (P < .001).

Conclusion Early structural lung disease is heterogeneously distributed in the lung. Quantitative scoring tools for studies using chest CT as an end point, and mechanistic studies that seek to better understand the pathogenesis of early cystic fibrosis lung disease, should take account of this differential topographic expression of disease early in life.
Keyword Gastroesophageal-reflux
Airway inflammation
Pulmonary-function
Young-children
Disease
Infants
Adults
Q-Index Code C1
Q-Index Status Confirmed Code
Grant ID Sly040A
513730
Institutional Status UQ
Additional Notes Portions of this study were presented at the Royal Australian and New Zealand College of Radiologists' Annual Scientific Meeting in 2010, Perth, Australia and the Thoracic Society of Australia and New Zealand's Annual Scientific Meeting in 2012, Canberra, Australia.

 
Versions
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 23 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 30 times in Scopus Article | Citations
Google Scholar Search Google Scholar
Created: Sun, 11 Aug 2013, 10:06:44 EST by System User on behalf of Child Health Research Centre