Changes in structural lung disease in cystic fibrosis children over 4 years as evaluated by high-resolution computed tomography
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To compare the worsening of structural lung disease on high-resolution computed tomography (HRCT) with changes in spirometry results in cystic fibrosis (CF) patients, and analyse factors associated with the worsening of structural lung disease over time.
A total of 31 CF subjects (mean age 11.03 ± 3.67 years old) were prospectively evaluated by two HRCT and spirometry tests performed 4 years apart. HRCT abnormalities were scored using the Bhalla scoring system. Comparisons between changes on HRCT and spirometry were made for all patients, and also for groups categorized by age, sex, genotypic alterations and lung obstruction.
The mean HRCT Bhalla scoring, forced expiratory volume in 1 s (FEV1 %pred.) and forced vital capacity (FVC %pred.) were 7.92 ± 3.59, 87.76 ± 20.52 and 96.54 ± 15.12, respectively. There was a significant deterioration in the Bhalla score (p < 0.01) and in certain categories: severity of bronchiectasis, peribronchial thickening, mucous plugging and bronchial divisions. Females had a more pronounced worsening of the Bhalla score than males (p = 0.048). No change over time was found in FEV1 and FVC. Only sex was associated with a deterioration in HRCT.
HRCT Bhalla scoring changes statistically significantly over 4 years, but spirometry results do not. Worsening on HRCT is more evident in females.
• HRCT Bhalla scoring changes significantly over 4 years, spirometry results do not.
• Females experience faster respiratory deterioration than males.
• Spirometry results are not associated with deterioration in HRCT.
KeywordsBronchiectasis Cystic fibrosis Spirometry Thoracic radiography Computed tomography X-ray
Abbreviations and acronyms
Forced expiratory volume in one second
Forced vital capacity
High-resolution computed tomography
Difference in computed tomography scoring between 4-year follow-up and basal evaluation
Lung function test
Difference in lung function tests between 4-year follow-up and baseline evaluation
The scientific guarantor of this publication is Dr. Paloma Caballero. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. We would like to thank the Department of Statistics at La Princesa Hospital, Madrid, Spain, for kindly providing statistical advice for this manuscript. Institutional Review Board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Some study subjects or cohorts have not been previously reported. Methodology: prospective, prognostic, observational study, performed at two institutions.
- 33.Albi G. La tomografía computarizada de alta resolución en pacientes pediátricos con fibrosis quística: correlación con la radiografía del tórax, la espirometría y los datos clínicos. Estudio dosimétrico [dissertation]. [Madrid (Spain)]: Autónoma de Madrid University; 2009. 140 p. https://repositorio.uam.es/xmlui/bitstream/handle/10486/4324/29122_albi_rodriguez_gustavo.pdf?sequence=1. Accessed 1 Oct 2014