Quantitative assessment of chronic lung disease of infancy using computed tomography

• Published in: The European respiratory journal Vol. 39; no. 4; pp. 992 - 999
• Main Authors: Sarria, E.E., Mattiello, R., Rao, L., Tiller, C.J., Poindexter, B., Applegate, K.E., Granroth-Cook, J., Denski, C., Nguyen, J., Yu, Z., Hoffman, E., Tepper, R.S.
• Format: Journal Article
• Language: English
• Published: Leeds Maney 01.04.2012
• Subjects: Age Factors; Biological and medical sciences; Bronchopulmonary Dysplasia - diagnostic imaging; Bronchopulmonary Dysplasia - physiopathology; Child, Preschool; Chronic Disease; Diseases of mother, fetus and pregnancy; Female; Gestational Age; Gynecology. Andrology. Obstetrics; Humans; Infant; Infant, Newborn; Intensive Care, Neonatal; Lung - diagnostic imaging; Lung - growth & development; Lung - physiopathology; Lung Volume Measurements - methods; Male; Medical sciences; Pneumology; Pregnancy. Fetus. Placenta; Respiration, Artificial; Respiratory system : syndromes and miscellaneous diseases; Severity of Illness Index; Tomography, X-Ray Computed - methods; Human; Premature; Lung disease; High resolution; Radiodiagnosis; Respiratory disease; Chronic disease; high-resolution computed tomography; Lung; Infant; Lung volume; Newborn diseases; Volume measurement; Development; lung volume measurement; Medical imagery; Bronchus disease; Bronchopulmonary dysplasia; Computerized axial tomography; lung development; Quantitative analysis; Pneumology
• ISSN: 0903-1936; 1399-3003; 1399-3003
• DOI: 10.1183/09031936.00064811

The aims of this study were to determine whether infants and toddlers with chronic lung disease of infancy (CLDI) have smaller airways and lower lung density compared with full-term healthy controls. Multi-slice computed tomography (CT) chest scans were obtained at elevated lung volumes during a brief respiratory pause in sedated infants and toddlers; 38 CLDI were compared with 39 full-term controls. For CLDI subjects, gestational age at birth ranged from 25 to 29 weeks. Airway size was measured for the trachea and the next three to four generations into the right lower lobe; lung volumes and tissue density were also measured. The relationship between airway size and airway generation differed between the CLDI and full-term groups; the sizes of the first and second airway generations were larger in the shorter CLDI than in the shorter full-term subjects. The increased size in the airways in the CLDI subjects was associated with increasing mechanical ventilation time in the neonatal period. CLDI subjects had a greater heterogeneity of lung density compared with full-term subjects. Our results indicate that quantitative analysis of multi-slice CT scans at elevated volumes provides important insights into the pulmonary pathology of infants and toddlers with CLDI.