Quantitative CT scans of lung parenchymal pathology in premature infants ages 0–6 years

Spielberg, D.R.; Walkup, Laura L.; Stein, Jill; Crotty, Eric J.; Rattan, Mantosh S.; Hossain, Monir; Brody, Alan S.; Woods, Jason C.

doi:10.1002/ppul.23921

Cited by 20 publications

(25 citation statements)

References 39 publications

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“…When Boechat et al 101 applied a scoring system based on High‐resolution computed tomography (HRCT) abnormalities to the youngest infants, they found it was able to identify those likely to develop respiratory morbidities in the first year of life. Other studies confirmed a good correlation between CT abnormalities and clinical scores at 36 weeks PMA, duration of oxygen therapy, and risk of hospitalization for respiratory tract infections 102‐104 . HRCT abnormalities correlate better with BPD than CR 98,105 …”

Section: Computed Tomographymentioning

confidence: 79%

“…Other studies confirmed a good correlation between CT abnormalities and clinical scores at 36 weeks PMA, duration of oxygen therapy, and risk of hospitalization for respiratory tract infections. 102 , 103 , 104 HRCT abnormalities correlate better with BPD than CR. 98 , 105 …”

Section: Computed Tomographymentioning

confidence: 90%

“…Chest CT frequently shows bronchial wall thickening, hypoattenuation, emphysematous areas and linear or triangular opacities in preterm‐born infants and toddlers with BPD, 104 , 106 and these signs tend to decrease with age. 103 , 107 …”

Section: Computed Tomographymentioning

confidence: 99%

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Lung growth and pulmonary function after prematurity and bronchopulmonary dysplasia

Moschino

Bonadies

Baraldi

2021

Pediatric Pulmonology

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Bronchopulmonary dysplasia (BPD) still carries a heavy burden of morbidity and mortality in survivors of extreme prematurity. The disease is characterized by simplification of the alveolar structure, involving a smaller number of enlarged alveoli due to decreased septation and a dysmorphic pulmonary microvessel growth. These changes lead to persistent abnormalities mainly affecting the smaller airways, lung parenchyma, and pulmonary vasculature, which can be assessed with lung function tests and imaging techniques. Several longitudinal lung function studies have demonstrated that most preterm‐born subjects with BPD embark on a low lung function trajectory, never achieving their full airway growth potential. They are consequently at higher risk of developing a chronic obstructive pulmonary disease‐like phenotype later in life. Studies based on computer tomography and magnetic resonance imaging, have also shown that in these patients there is a persistence of lung abnormalities like emphysematous areas, bronchial wall thickening, interstitial opacities, and mosaic lung attenuation also in adult age. This review aims to outline the current knowledge of pulmonary and vascular growth in survivors of BPD and the evidence of their lung function and imaging up to adulthood.

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Section: Computed Tomographymentioning

confidence: 79%

Section: Computed Tomographymentioning

confidence: 90%

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Lung growth and pulmonary function after prematurity and bronchopulmonary dysplasia

Moschino

Bonadies

Baraldi

2021

Pediatric Pulmonology

View full text Add to dashboard Cite

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“…Scoring systems for CT of the chest exist to define clinical phenotypes and predict short-and long-term prognosis. 78,79 Given concerns for ionizing radiation, pulmonary MRI holds promise, with the ability to apply similar scoring systems to quantify parenchymal disease. 80…”

Section: Parenchymalmentioning

confidence: 99%

Bronchopulmonary Dysplasia: Then, Now, and Next

Tracy

Cornfield

2020

Pediatric Allergy, Immunology, and Pulmonology

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Bronchopulmonary dysplasia (BPD) has evolved considerably since its first description over 50 years ago. This review aims to provide a historical framework for conceptualizing BPD and a current understanding of the changing definition, epidemiology, pathophysiology, treatment, and outcomes of BPD. The transdisciplinary approach that led to the initial phenotypic description of BPD continues to hold promise today. Investigators are refining the definition of BPD in light of changes in clinical care and increasing survival rates of very preterm infants. Despite improvements in perinatal care the incidence of BPD continues to increase. There is growing recognition that antenatal risk factors play a key role in the development of BPD. Strategies designed to prevent or limit neonatal lung injury continue to evolve. Defining the phenotype of infants with BPD can meaningfully direct treatment. Infants with BPD benefit from an interdisciplinary approach to longitudinal care with a focus on growth and neurocognitive development. While the ultimate impact of BPD on long-term pulmonary morbidity remains an active area of investigation, current data indicate that most children and adolescents with a history of BPD have a quality of life comparable to that of other preterm infants.

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“…A low attenuation threshold of −950 HU at full inspiration has been applied in most investigations to identify lung areas affected by emphysema, and by using this threshold it has been shown that CT-quantified disease severity predicts lung function decline [ 4 , 5 ]. Quantitative chest CT has also been utilized in an increasing number of pediatric studies to evaluate the severity of obstructive lung disease such as bronchopulmonary dysplasia, cystic fibrosis, post-infectious bronchiolitis obliterans (PIBO), bronchiolitis obliterans in perinatally HIV-infected adolescents and bronchiolitis obliterans syndrome (BOS) following lung or hematopoietic stem cell transplantation (HSCT), all of which are characterized by air-trapping and volume loss due to atelectasis and fibrosis [ 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

Low- and High-Attenuation Lung Volume in Quantitative Chest CT in Children without Lung Disease

et al. 2021

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In contrast to studies of adults with emphysema, application of fixed thresholds to determine low- and high-attenuation areas (air-trapping and parenchymal lung disease) in pediatric quantitative chest CT is problematic. We aimed to assess age effects on: (i) mean lung attenuation (full inspiration); and (ii) low and high attenuation thresholds (LAT and HAT) defined as mean attenuation and 1 SD below and above mean, respectively. Chest CTs from children aged 6–17 years without abnormalities were retrieved, and histograms of attenuation coefficients were analyzed. Eighty examinations were included. Inverse functions described relationships between age and mean lung attenuation, LAT or HAT (p < 0.0001). Predicted value for LAT decreased from −846 HU in 6-year-old to −950 HU in 13- to 17-year-old subjects (cut-off value for assessing emphysema in adults). %TLCCT with low attenuation correlated with age (rs = −0.31; p = 0.005) and was <5% for 9–17-year-old subjects. Inverse associations were demonstrated between: (i) %TLCCT with high attenuation and age (r2 = 0.49; p < 0.0001); (ii) %TLCCT with low attenuation and TLCCT (r2 = 0.47; p < 0.0001); (iii) %TLCCT with high attenuation and TLCCT (r2 = 0.76; p < 0.0001). In conclusion, quantitative analysis of chest CTs from children without lung disease can be used to define age-specific LAT and HAT for evaluation of pediatric lung disease severity.

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Quantitative CT scans of lung parenchymal pathology in premature infants ages 0–6 years

Cited by 20 publications

References 39 publications

Lung growth and pulmonary function after prematurity and bronchopulmonary dysplasia

Lung growth and pulmonary function after prematurity and bronchopulmonary dysplasia

Bronchopulmonary Dysplasia: Then, Now, and Next

Low- and High-Attenuation Lung Volume in Quantitative Chest CT in Children without Lung Disease

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