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


METHODS
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.


RESULTS
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.


CONCLUSIONS
HRCT Bhalla scoring changes statistically significantly over 4 years, but spirometry results do not. Worsening on HRCT is more evident in females.


CONCLUSIONS
• 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.
Department of Respiratory Medicine, University Hospital La Paz, La Paz Hospital Research Institute, Paseo de la Castellana, 261, 28046, Madrid, Spain. carlinjavier@hotmail.com.
Carlos
C
Carpio
Department of Radiology, Niño de Jesús Children's Hospital, Madrid, Spain.
Gustavo
G
Albi
Department of Radiology, University Hospital La Princesa, Madrid, Spain.
José Carlos
JC
Rayón-Aledo
Department of Respiratory Medicine, University Hospital La Paz, La Paz Hospital Research Institute, Paseo de la Castellana, 261, 28046, Madrid, Spain.
Rodolfo
R
Álvarez-Sala
Department of Respiratory Medicine, University Hospital La Princesa, Madrid, Spain.
Rosa
R
Girón
Department of Respiratory Medicine, University Hospital La Paz, La Paz Hospital Research Institute, Paseo de la Castellana, 261, 28046, Madrid, Spain.
Concepción
C
Prados
Department of Radiology, University Hospital La Princesa, Madrid, Spain.
Paloma
P
Caballero
D000293:Adolescent; D001987:Bronchiectasis / Q000000981:diagnostic imaging; D002648:Child; D003550:Cystic Fibrosis / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D011446:Prospective Studies; D012720:Severity of Illness Index; D013147:Spirometry / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods*
Bronchiectasis; Computed tomography; Cystic fibrosis; Spirometry; Thoracic radiography; X-ray