BRONCHOPULMONARY DYSPLASIA - VALUE OF CT IN IDENTIFYING PULMONARY SEQUELAE
BRONCHOPULMONARY DYSPLASIA - VALUE OF CT IN IDENTIFYING PULMONARY SEQUELAE
复制标题
DOI：
10.2214/ajr.163.1.8010206
复制
发表时间：
1994-07-01
影响因子：
5
通讯作者：
LALLEMAND, D
中科院分区：
文献类型：
--
作者：
OPPENHEIM, C;MAMOUMANI, T;LALLEMAND, D
OBJECTIVE.肺功能障碍在支气管肺发育不良的儿童中很常见。胸片对支气管肺发育不良后遗症的鉴别并不令人满意，因为尽管胸片经常显示异常，但异常通常很小，有时不存在。因此，我们评估了CT在鉴别支气管肺发育不良后遗症中的价值。23名新生儿支气管肺发育不良存活且有慢性肺功能障碍体征（咳嗽、喘息、呼吸困难、肺炎、呼吸功能不全反复发作）的儿童（平均年龄4岁）接受胸部X线片和胸部高分辨率CT扫描检查。两名评审员通过描述最一致发现的病变及其频率定性分析了胸部X线和CT结果。23例患儿中17例胸片表现为过度膨胀，11例表现为透亮区，10例表现为线状阴影。没有观察到胸膜增厚，4名儿童的胸片正常。所有23例CT扫描均显示异常，包括多灶性过度通气区、边界清晰的线性阴影和三角形胸膜下阴影（外底内尖）。在23名儿童中，有20名存在所有三种异常。另外3例患儿中，发现2例异常，均未发现支气管扩张。支气管肺发育不良伴慢性肺功能不全的幸存者的病变在CT扫描上比在胸片上显示得更好。重要的是，多灶性过度通气区、多个连续切片上可见的面对三角形胸膜下阴影的许多线性阴影以及无支气管扩张的CT结果应提示存在支气管肺发育不良的后遗症。
OBJECTIVE. Pulmonary dysfunction is common in children who survive bronchopulmonary dysplasia. Chest radiographs are not satisfactory for the identification of the sequelae of bronchopulmonary dysplasia because, although they often show abnormalities, the abnormalities are usually minor and sometimes absent. We therefore assessed the value of CT for identifying the sequelae of bronchopulmonary dysplasia.MATERIALS AND METHODS. Twenty-three children (mean age, 4 years) who had survived neonatal bronchopulmonary dysplasia and had signs of chronic pulmonary dysfunction (recurrent episodes of coughing, wheezing, dyspnea, pneumonia, respiratory insufficiency) were examined with chest radiographs and high-resolution CT scans of the chest. Two reviewers qualitatively analyzed the chest radiographic and CT findings by describing the most consistently found lesions and their frequencies.RESULTS. The chest radiographs showed hyperexpansion in 17, hyperlucent areas in 11, and linear opacities in 10 of the 23 children. Pleural thickening was not observed, and four children had normal findings on chest radiographs. All 23 CT scans showed abnormalities, including multifocal areas of hyperaeration, well-defined linear opacities, and triangular subpleural opacities with an external base and an internal apex. In 20 of 23 children, all three abnormalities were present. For the three other children, two of these three abnormalities were found. No bronchiectasis was observed in any of the cases.CONCLUSION. Lesions in survivors of bronchopulmonary dysplasia with chronic pulmonary dysfunction are visualized better on CT scans than on chest radiographs. Importantly CT findings of multifocal areas of hyperaeration, numerous linear opacities facing triangular subpleural opacities visible on several consecutive sections, and no bronchiectasis should suggest the presence of sequelae of bronchopulmonary dysplasia.