Chest CT findings in pediatric Wegener's granulomatosis.
BACKGROUND
Although pulmonary involvement occurs in the majority of children and adolescents with Wegener's granulomatosis (WG), relatively little has been published regarding the CT imaging manifestations in this group of patients.


OBJECTIVE
To determine the frequency and types of chest CT abnormalities in active pediatric WG (pWG).


METHODS
The study was a retrospective examination of 29 chest CT examinations performed at diagnosis (n=14) and during disease flares (n=15) in 18 children.


RESULTS
The most common abnormalities were nodules (seen in 90% of examinations), ground-glass opacification (52%), and air-space opacification (45%). Of examinations with nodules, 73% demonstrated nodules >5 mm in diameter and 69% demonstrated more than five nodules; 17% had cavitary lesions. The only abnormality with a significant difference in prevalence between diagnosis and disease flares was air-space opacification, present in 71% and 20%, respectively (P < 0.01).


CONCLUSIONS
In accordance with the findings of published adult studies and at variance with those of prior pediatric studies, our findings indicate that chest CT abnormalities in active pWG are frequent, most commonly comprising nodules and ground-glass opacification, which may be difficult to detect on plain radiography. We therefore advocate the routine use of chest CT for all affected patients, both at the time of presentation and during disease flares.
Levine
Daniel
D
Department of Radiology and Nuclear Medicine, British Columbia Children's Hospital, 4480 Oak Street, Vancouver, British Columbia, Canada V6H 3V4. daniel.levine@mac.com
Akikusa
Jonathan
J
Manson
David
D
Silverman
Earl
E
Schneider
Rayfel
R
D000293:Adolescent; D002648:Child; D005260:Female; D014890:Granulomatosis with Polyangiitis / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D013902:Radiography, Thoracic; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed