Chest imaging findings in children with cystic fibrosis

Abstract

Cystic fibrosis (CF) is an inherited chronic life-threatening disease that most critically affects the lungs. It causes the production ofsticky mucus that clogs the lungs and leads to inflammation. The severity of lung damage determines the evolution of the disease and requires instrumental confirmation. Research was performed to determinate the structural changes of the lung tissue in children with CF by the conventional chest X-ray and thorax spiral computed tomography (CT). In this study we evaluated the chest X-raysof 55 patients (32 girls and 23 boys) and the CT scans of 36 patients with CF (21 girls and 15 boys), from 2 to 18 years. Four patients had a mild evolution of CF, 10 children had moderate, and 21 suffered from the severe form of the disease. The most common chest radiographic findings in CF patients were hyperinflation (87.3%), bronchial thickening (94.5%) and dilatation (41.8%), an increase in interstitial markings (76.3%), and pneumofibrosis (85.4%). Abnormal findings were detected in 94.4% patients examined by CT. Bronchiectasis developed in 77.7% CF patients, including 28.6% cases in the upper or mid lobes and 71.4% children with generalized bronchiectasis. Cysticbronchus deformations withliquid levels were identified in 2 of the patients with severe evolution of CF. Sectors of fibrosis were revealed in 6 spiral CT images. In two of the CF children CT findings of chronic obstructive bronchitis were detected, and in other two patients no structural bronchial changes were founded. The method of spiral tomography offeredmore complete and detailed information about the anatomo-morphological substrate of pulmonary modifications in children with cystic fibrosis. In children with CF structural bronchopulmonaryspiral CTsreveals modifications such as focal fibrosis, and sometimes widespread bronchial deformations with saccate bronchiectasis.