Assessment of early bronchiectasis in young children with cystic fibrosis is dependent on lung volume

Mott L.S., Graniel K.G., Park J., De Klerk N.H., Sly P.D., Murray C.P., Tiddens H.A.W.M. and Stick S.M. (2013) Assessment of early bronchiectasis in young children with cystic fibrosis is dependent on lung volume. Chest, 144 4: 1193-1198. doi:10.1378/chest.12-2589


Author Mott L.S.
Graniel K.G.
Park J.
De Klerk N.H.
Sly P.D.
Murray C.P.
Tiddens H.A.W.M.
Stick S.M.
Title Assessment of early bronchiectasis in young children with cystic fibrosis is dependent on lung volume
Journal name Chest   Check publisher's open access policy
ISSN 0012-3692
1931-3543
Publication date 2013-01-01
Sub-type Article (original research)
DOI 10.1378/chest.12-2589
Volume 144
Issue 4
Start page 1193
End page 1198
Total pages 6
Place of publication Northbrook, IL, U.S.A.
Publisher American College of Chest Physicians
Language eng
Subject 2740 Pulmonary and Respiratory Medicine
2706 Critical Care and Intensive Care Medicine
2705 Cardiology and Cardiovascular Medicine
Abstract Objective: The aim of this study was to determine whether assessment of early CT scan-detected bronchiectasis in young children with cystic fibrosis (CF) depends on lung volume. Methods: This study, approved by the hospital ethics committee, included 40 young children with CF from a newborn screened population contributing paired volume-controlled inspiratory and expiratory volumetric chest CT scans acquired under general anesthesia while clinically stable. Bronchiectasis was assessed with a semiquantitative CT scan score in inspiration and expiration, and the sensitivity of the expiratory CT scan to detect bronchiectasis was compared with the inspiratory CT scan by sensitivity and intraclass correlation coefficient analysis and Bland-Altman plots. Matched inspiratory and expiratory airway-vessel measurements were obtained in a subset of 10 children, and the relationship between lung volume and airway:vessel ratio after adjusting for age and vessel size was examined with the use of a linear regression model with generalized estimating equations. The number of visible airways in inspiration and expiration was compared in all 40 children by Wilcoxon signed rank test. Results: Expiratory scans had poor sensitivity (0.46) to detect bronchiectasis, underestimating disease extent (P < .001). Airway:vessel ratios were consistently higher in inspiration, independent of age and vessel size (P < .001), with significantly more airways visible in inspiration than in expiration, independent of age (median, 71 vs 28, respectively; P < .001). Conclusions: In young children with CF, radiologic assessment of early bronchiectasis with chest CT scan depends on lung volume; thus, expiratory scans may not be appropriate for evaluating bronchiectasis in this population. Lung volume during CT image acquisition should be standardized to evaluate airway dimensions in young children.
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
Queensland Children's Medical Research Institute Publications
 
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