[Thoracic imaging in cystic fibrosis : Radiography]

Abstract

Clinical issue: Patients with cystic fibrosis (CF) require regular follow-up examinations, usually from birth onwards, using imaging techniques.

Methods: The conventional chest x‑ray examination is the only technique recommended by the guidelines at this age. The examination can be performed at every age and is well standardized. The radiation dose to the patient is small and does not require any sedation.

Radiological findings and classification: The typical structural changes of the bronchi and the lung parenchyma can be depicted. Typical findings are air-trapping, bronchiectasis, peribronchial cuffing, bronchial wall thickening, mucus plugging, nodular opacities, atelectasis and/or consolidations and hilar lymphadenopathy. Different scoring systems have been developed to allow for a relatively easy but reproducible assessment of the severity of the disease. The most important ones for daily clinical practice are the Chrispin-Norman score, Brasfield score, and the Wisconsin score. All of them show a good correlation with pulmonary function parameters and the clinical picture of the patients.

Practical recommendations: It is recommended to take an annual X‑ray for patients with CF, and in addition in individual cases with clinical deterioration. Computed tomography (CT) can be performed if relevant information for treatment is expected to gained.

Keywords: Bronchiectasis; Chest x‑ray; Cystic fibrosis; Mucus plugging; Scoring.