Diagnostic value of chest CT combined with x-ray for premature infants with bronchopulmonary dysplasia

Abstract

Bronchopulmonary dysplasia (BPD) is a common chronic lung disease in the newborns. Staging of BPD severity does not have a high predictive value for the outcomes. This study was aimed to assess the diagnostic value of chest computed tomography (CT) combined with x-ray for premature infants with BPD.Twenty-five premature infants with mild BPD and 20 premature infants with moderate to severe BPD treated at our hospital from January 2015 to December 2015 were randomly selected. The imaging features were compared between premature infants with different severity of BPD.In mild BPD group, the incidence of increased lung opacity (at 3-10 and 29 days) were significantly higher than those in infants with moderate to severe BPD (P = .034, P = .003, respectively). However, the incidences of stage III BPD (3-10 days) and stage IV BPD (11-27 days) were significantly lower in infants with mild BPD than those in infants with moderate to severe BPD (P = .013, P = .033, respectively). The chest x-ray score in the mild BPD group was significantly lower than that in moderate to severe BPD group [3.0 (1.0) vs 5.0 (1.0), P < .001]. Spearman rank correlation analysis indicated that chest x-ray score had significant correlation (r = 0.787, P < .001) with the clinical severity. In the mild BPD group, the chest CT scan score was 11.52 ± 3.49, which was considerably lower than that in the moderate to severe BPD group (24.70 ± 4.32) (P < .001). Moreover, the severity of BPD in the premature infants was significantly correlated to the chest CT scan score (r = 0.855, P < .001).Chest CT combined with x-ray is an effective method for predicting the severity of BPD in premature infants.

Figure 1

Chest radiographic manifestations in premature infants with BPD. (A) Increased lung opacity; (B) Grade I RDS; (C) Stage III BPD; (D) Stage IV BPD. BPD = bronchopulmonary dysplasia, RDS = respiratory distress syndrome.

Figure 2

CT images of 2 premature infants with BPD. (A) In case 1, pulmonary hyperinflation was found in the anterior segment of the right upper lobe (arrow) and pulmonary parenchymal lesions were observed in the anterior-posterior segment of the right lobe and the left lobe (triangle), with CT score of 12 (pulmonary hyperinflation and parenchymal lesions in 6 segments); (B) In case 2, pulmonary hyperinflation was found in the lateral basal segment and posterior basal segment of the left lower lobe (arrow) and parenchymal lesions were observed in the lateral left lower lobe and posterior basal segment (triangle), with CT score of 24 (pulmonary hyperinflation in 13 segments and parenchymal lesions in 11 segments). CT = computed tomography.