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Retrospective review of children presenting with non cystic fibrosis bronchiectasis: HRCT features and clinical relationships.
Pediatr Pulmonol 2003; 36(2):87-93PP

Abstract

Non cystic fibrosis (CF) bronchiectasis in children presents with a spectrum of disease severity. Our aims were to document the extent and severity of disease in children with non-CF bronchiectasis, to review the inter- and intraobserver agreement for the high-resolution computed tomography (HRCT) features examined, and to assess correlations between HRCT features and clinical measures of severity. We performed a retrospective review of 56 children from the Starship Children's Hospital. HRCT scans were scored by a modified Bhalla system, and the chest X-rays using the Brasfield score. Scores were correlated with demographics, number of hospitalizations, disease duration, pulmonary function, clinical examination, and chronic sputum infection. The bronchiectasis seen was widespread and severe, particularly in Maori and Pacific Island children. The kappa coefficient for intraobserver agreement was better than that for interobserver agreement. Comparisons between HRCT scan and lung function parameters showed that the strongest relationships were between forced expiratory volume in 1 sec (FEV(1)) and forced expiratory flow between 25-75% of forced vital capacity (FEF(25-75)) with the extent of bronchiectasis, bronchial wall thickening, and air trapping. Children with digital clubbing and chest deformity showed significantly higher scores for extent of bronchiectasis, bronchial wall dilatation and thickness, and overall computed tomography (CT) score. No relationship was demonstrated between chronic sputum infection and CT score. The HRCT score demonstrated a stronger correlation between the extent and severity of bronchiectasis, and spirometry values, than the chest X-ray score. In conclusion, pediatric non-CF bronchiectasis in Auckland is extensive and severe. The good intraobserver ratings mean that consistency of scoring is possible on repeated scans. This study cannot comment on the relationships of CT and less severe disease.

Authors+Show Affiliations

Department of Paediatrics, University of Auckland, New Zealand. liz.edwards@bigfoot.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

12833486

Citation

Edwards, E A., et al. "Retrospective Review of Children Presenting With Non Cystic Fibrosis Bronchiectasis: HRCT Features and Clinical Relationships." Pediatric Pulmonology, vol. 36, no. 2, 2003, pp. 87-93.
Edwards EA, Metcalfe R, Milne DG, et al. Retrospective review of children presenting with non cystic fibrosis bronchiectasis: HRCT features and clinical relationships. Pediatr Pulmonol. 2003;36(2):87-93.
Edwards, E. A., Metcalfe, R., Milne, D. G., Thompson, J., & Byrnes, C. A. (2003). Retrospective review of children presenting with non cystic fibrosis bronchiectasis: HRCT features and clinical relationships. Pediatric Pulmonology, 36(2), pp. 87-93.
Edwards EA, et al. Retrospective Review of Children Presenting With Non Cystic Fibrosis Bronchiectasis: HRCT Features and Clinical Relationships. Pediatr Pulmonol. 2003;36(2):87-93. PubMed PMID: 12833486.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Retrospective review of children presenting with non cystic fibrosis bronchiectasis: HRCT features and clinical relationships. AU - Edwards,E A, AU - Metcalfe,R, AU - Milne,D G, AU - Thompson,J, AU - Byrnes,C A, PY - 2003/7/2/pubmed PY - 2003/12/17/medline PY - 2003/7/2/entrez SP - 87 EP - 93 JF - Pediatric pulmonology JO - Pediatr. Pulmonol. VL - 36 IS - 2 N2 - Non cystic fibrosis (CF) bronchiectasis in children presents with a spectrum of disease severity. Our aims were to document the extent and severity of disease in children with non-CF bronchiectasis, to review the inter- and intraobserver agreement for the high-resolution computed tomography (HRCT) features examined, and to assess correlations between HRCT features and clinical measures of severity. We performed a retrospective review of 56 children from the Starship Children's Hospital. HRCT scans were scored by a modified Bhalla system, and the chest X-rays using the Brasfield score. Scores were correlated with demographics, number of hospitalizations, disease duration, pulmonary function, clinical examination, and chronic sputum infection. The bronchiectasis seen was widespread and severe, particularly in Maori and Pacific Island children. The kappa coefficient for intraobserver agreement was better than that for interobserver agreement. Comparisons between HRCT scan and lung function parameters showed that the strongest relationships were between forced expiratory volume in 1 sec (FEV(1)) and forced expiratory flow between 25-75% of forced vital capacity (FEF(25-75)) with the extent of bronchiectasis, bronchial wall thickening, and air trapping. Children with digital clubbing and chest deformity showed significantly higher scores for extent of bronchiectasis, bronchial wall dilatation and thickness, and overall computed tomography (CT) score. No relationship was demonstrated between chronic sputum infection and CT score. The HRCT score demonstrated a stronger correlation between the extent and severity of bronchiectasis, and spirometry values, than the chest X-ray score. In conclusion, pediatric non-CF bronchiectasis in Auckland is extensive and severe. The good intraobserver ratings mean that consistency of scoring is possible on repeated scans. This study cannot comment on the relationships of CT and less severe disease. SN - 8755-6863 UR - https://www.unboundmedicine.com/medline/citation/12833486/Retrospective_review_of_children_presenting_with_non_cystic_fibrosis_bronchiectasis:_HRCT_features_and_clinical_relationships_ L2 - https://doi.org/10.1002/ppul.10339 DB - PRIME DP - Unbound Medicine ER -