The systematic evaluation of the chest radiograph in cystic fibrosis

Abstract

Abstract. In antero-posterior and lateral chest radiographs of patients with cystic fibrosis changes may be observed which reflect underlying lung abnormalities. Increases in lung volume can result in forward bowing of the sternum, diaphragmatic depression and spinal kyphosis. Parenchymal lung changes which are directly or indirectly a consequence of bronchiolar mucus plugging with infection, include mottled shadowing and ring shadowing. Prominence of bronchial line shadows is also commonly seen. Large shadows due to confluent consolidation or collapse may occur. --This paper gives a technique for the systematic evaluation of these changes which are then represented in numerical terms. The method gives repeatable results. The information recorded facilitates comparison of chest radiographs with each other and the comparison of radiological features with clinical and physiological assessments.

Fibronectin-Cleaving Activity in Bronchial Secretions of Patients with Cystic Fibrosis

“…Severity of the disease was graded in five stages (I-V). Radiographic scoring was done with the scoring system of Chrispin and Norman [15]. The highest stage (V) corresponds to poor pulmonary condition and advanced radiographic alterations of cystic fibrosis.…”

Assessment of hyperpolarized 3He lung MRI for regional evaluation of interventional therapy: A pilot study in pediatric cystic fibrosis

“…This leads to progressive lung disease, a reduction in ventilated volume, and eventually respiratory failure. Management of pediatric CF patients currently relies on clinical status, lung function tests, sputum cultures, and antiquated scoring systems based on chest x-ray (CXR) (3). None of these tests give information about regional lung function or are sensitive enough to demonstrate subtle changes that may aid in assessing early lung disease status, planning therapy, or evaluating response to treatment.…”

“…In any longitudinal assessment of lung function, reliability and reproducibility is paramount; hence, we first examined the reproducibility of ventilated volume measurements obtained with hyperpolarized 3 He MRI. We then used the same method in a pilot study to evaluate the immediate effects of a standard course of chest physiotherapy on regional ventilated lung volumes in a further group of nine age-matched children with CF.…”

Imaging of Cystic Fibrosis Lung Disease and Clinical Interpretation

“…Bronchiectasis may appear as superimposed line shadows and ring shadows on CXR, depending on the course of the airway in relation to the image plane (• ▶ Fig. 3, 4) [13,35]. Affection of the small airways, which are usually not visualized by CXR, may lead to visibility of grouped mottled shadows.…”

“…To quantify disease severity and facilitate patient follow-up and monitoring of therapeutic effects in CF, visual scoring systems have been developed for CXR (e. g. Chrispin-Norman Score, Brasfield Score, Wisconsin Score) [15,35,48,49], CT (e. g. Bhalla Score, Helbich Score, Brody Score) [4, 50,51], and more recently, MRI (Eichinger Score) [39]. These scoring systems are necessary because the described changes in the CF lung show a heterogeneous distribution within one patient and between different patients, and may intra-individually show a different course over time.…”