European Radiology

, Volume 25, Issue 12, pp 3577–3585 | Cite as

Changes in structural lung disease in cystic fibrosis children over 4 years as evaluated by high-resolution computed tomography

  • Carlos CarpioEmail author
  • Gustavo Albi
  • José Carlos Rayón-Aledo
  • Rodolfo Álvarez-Sala
  • Rosa Girón
  • Concepción Prados
  • Paloma Caballero
Computed Tomography



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.

Key Points

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.


Bronchiectasis Cystic fibrosis Spirometry Thoracic radiography Computed tomography X-ray 

Abbreviations and acronyms


Cystic fibrosis


Computed tomography


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.


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Copyright information

© European Society of Radiology 2015

Authors and Affiliations

  • Carlos Carpio
    • 1
    Email author
  • Gustavo Albi
    • 2
  • José Carlos Rayón-Aledo
    • 3
  • Rodolfo Álvarez-Sala
    • 1
  • Rosa Girón
    • 4
  • Concepción Prados
    • 1
  • Paloma Caballero
    • 3
  1. 1.Department of Respiratory MedicineUniversity Hospital La Paz, La Paz Hospital Research InstituteMadridSpain
  2. 2.Department of RadiologyNiño de Jesús Children’s HospitalMadridSpain
  3. 3.Department of RadiologyUniversity Hospital La PrincesaMadridSpain
  4. 4.Department of Respiratory MedicineUniversity Hospital La PrincesaMadridSpain

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