Original articleA New Scoring System for Computed Tomography of the Chest for Assessing the Clinical Status of Bronchopulmonary Dysplasia
Section snippets
Patients
A total of 401 preterm infants under 37 weeks GA were hospitalized in the neonatal intensive care units of 3 hospitals (Kyushu University Hospital, National Hospital Organization Kyushu Medical Center, and Fukuoka Municipal Children’s Hospital) between July 1998 and January 2004 (Figure 1; available at www.jpeds.com); 51 of these infants (12.7%) developed BPD. After the hospitals’ Institutional Review Boards approved the study protocol, informed consent was obtained from the infants’
Interobserver Reproducibility
First, to confirm the objectivity and accuracy of the CT system, the reports from the radiologists were tested for interobserver reproducibility using Spearman’s rank-sum test and kappa statistics. The CT scores demonstrated close association among the radiologists (cc = 0.721 to 0.839; all P < .05; data not shown). Agreement between the radiologists in scoring each finding varied from κ = 0.059 to 0.444 for the mosaic pattern of lung attenuation to κ = 0.492 to 0.710 for the size of bullae and
Discussion
The CT scores significantly correlated with both the clinical scores at 36 weeks PMA and the duration of oxygen therapy. The CT scores were higher in patients who had more severe BPD, as well as in those who were discharged home on oxygen. On the other hand, the roentgenographic scores at 28 days of life, but not at 36 weeks PMA, correlated with both the clinical scores and the durations of oxygen therapy and the mechanical ventilation. Therefore, the CT scoring system may be reasonable for
References (19)
Lung Development: Biological and Clinical Perspectives
- et al.
Pulmonary disease following respirator therapy of hyaline membrane disease
N Eng J Med
(1967) - et al.
Serial changes in levels of IL-6 and IL-1β in premature infants at risk for bronchopulmonary dysplasia
Pediatr Pulmonol
(2001) - et al.
Comparison of tracheal aspirate and bronchoalveolar lavage specimens from premature infants
Biol Neonate
(2002) - et al.
Neonatology: Pathophysiology and Management of the Newborn
(2005) - et al.
NICHD/NHLBI/ORD workshop summary: bronchopulmonary dysplasia
Am J Respir Crit Care Med
(2001) - et al.
Clinical and roentgenographic scoring systems for assessing bronchopulmonary dysplasia
Am J Dis Child
(1984) - et al.
Bronchopulmonary dysplasia: value of CT in identifying pulmonary sequelae
Am J Roentgenol
(1994) - et al.
Pulmonary sequelae of bronchopulmonary dysplasia survivors: high-resolution CT findings
Am J Roentgenol
(2000)
Cited by (68)
Chest computed tomography in severe bronchopulmonary dysplasia: Comparing quantitative scoring methods
2023, European Journal of RadiologyImaging of bronchopulmonary dysplasia
2023, Seminars in PerinatologyPulmonary phenotypes of bronchopulmonary dysplasia in the preterm infant
2023, Seminars in PerinatologyImaging in neonatal respiratory disease
2022, Paediatric Respiratory ReviewsCitation Excerpt :There are several varying chest CT scoring systems that describe parenchymal structures of BPD in infancy, along with myriad CT imaging protocols [53], but with minimal standardization or routine implementation in a clinical setting. Studies have established that elevated CT lung scores correlate with duration of oxygen support and increased respiratory symptoms (e.g. wheezing, pneumonia, rehospitalization) [54,55], as well as impaired pulmonary function testing (PFT) measurements in older pediatric and adult survivors of BPD [56,57]. Chest CT is not commonly ordered in neonates, however, due to concerns about ionizing radiation exposure in young pediatric patients who may be particularly radiosensitive [58], in addition to the typical requirement for sedation/anesthesia and breath-hold maneuvers in neonatal patients.
Imaging: Radiography, lung ultrasound, and other imaging modalities
2022, Goldsmith's Assisted Ventilation of the Neonate: An Evidence-Based Approach to Newborn Respiratory Care, Seventh Edition