Published ahead of print on April 14, 2005, doi:10.1164/rccm.200410-1311OC
Am. J. Respir. Crit. Care Med., Volume 172, Number 2, July 2005, 218-224
A more recent version of this article appeared on July 15, 2005
Submitted on October 5, 2004
Accepted on April 12, 2005
Changes in Airway Dimensions on Computed Tomography Scans of Children With Cystic Fibrosis
Pim A de Jong1, Yasutaka Nakano2, Wim C Hop3, Frederick R Long4, Harvey O Coxson5, Peter D Pare6, and Harm A Tiddens7*
1 Department of Pediatric Pulmonology, Erasmus MC, Sophia Children's Hospital, University Medical Center, Rotterdam, The Netherlands; University of British Columbia, James Hogg iCAPTURE Center for Cardiovascular and Pulmonary Research, St Paul's Hospital, Vancouver, BC, Canada,
2 University of British Columbia, James Hogg iCAPTURE Center for Cardiovascular and Pulmonary Research, St Paul's Hospital, Vancouver, BC, Canada; Department of Respiratory Medicine, Shiga University of Medical Science, Shiga, Japan,
3 Department of Epidemiology and Biostatistics, Erasmus MC, Sophia Children's Hospital, University Medical Center, Rotterdam, The Netherlands,
4 The Children's Radiological Institute, Columbus Children's Hospital, Columbus, Ohio, USA,
5 Department of Radiology, Vancouver General Hospital, Vancouver, BC, Canada,
6 University of British Columbia, James Hogg iCAPTURE Center for Cardiovascular and Pulmonary Research, St Paul's Hospital, Vancouver, BC, Canada,
7 Department of Pediatric Pulmonology, Erasmus MC, Sophia Children's Hospital, University Medical Center, Rotterdam, The Netherlands
* To whom correspondence should be addressed. E-mail: h.tiddens{at}erasmusmc.nl.
Rationale: In cystic fibrosis (CF) chronic bacterial infection and inflammation lead to progressive airway wall thickening and lumen dilatation
Objectives: To quantify airway wall thickening and lumen dilatation in CF-children over a two-year
interval.
Methods: Children with CF (n=23) who had two CT scans (CTcf1 and CTcf2) combined with pulmonary function tests (PFTs) with a two-year interval between measurements were compared to control subjects (n=21) who had one CT (CTcontrols). On cross-sectional cut airway-artery pairs,
airway wall area (WA), airway lumen area (LA) and perimeter (Pi), and arterial area (AA) were quantified. LA/AA (=marker of bronchiectasis), airway wall thickness (AWT) and WA/AA (=markers of wall thickness) were calculated. CT scans were scored using 4 different scoring
systems. PFTs were expressed as percent predicted.
Results: Airway wall area to arterial area ratio (WA/AA) was 1.45 (p<0.001) and airway lumen area to arterial area ratio (LA/AA) was 1.92 times higher (p<0.001) in CF compared to age matched control subjects. LA/AA and WA/AA remained unchanged from CTcf1 to CTcf2 and did
not increase with age. AWT as a function of airway size increased from CTcf1 to CTcf2 by 2% (0.03 mm) (p = 0.02). The change in AWT was inversely related to the change in FEF25-75 (p=0.002).
Conclusions: In CF quantitative measurements of airways on CT scans show an increased ratio between airway lumen and arterial area and progressive airway wall thickening. Scoring systems show progression of bronchiectasis but unchanged airway wall thickness. PFTs remained stable.
Key words: Cystic Fibrosis, Tomography X-Ray Computed, Quantitative
evaluation, Airway wall, Child
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Copyright © 2005 American Thoracic Society
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