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
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