Changes in structural lung disease in cystic fibrosis children over 4 years as evaluated by high-resolution computed tomography.
OBJECTIVES
To compare the worsening of structural lung disease on high-resolution computed tomography (HRCT) with changes in spirometry results in cystic fibrosis (CF) patients, and analyse factors associated with the worsening of structural lung disease over time.


METHODS
A total of 31 CF subjects (mean age 11.03 ± 3.67 years old) were prospectively evaluated by two HRCT and spirometry tests performed 4 years apart. HRCT abnormalities were scored using the Bhalla scoring system. Comparisons between changes on HRCT and spirometry were made for all patients, and also for groups categorized by age, sex, genotypic alterations and lung obstruction.


RESULTS
The mean HRCT Bhalla scoring, forced expiratory volume in 1 s (FEV1 %pred.) and forced vital capacity (FVC %pred.) were 7.92 ± 3.59, 87.76 ± 20.52 and 96.54 ± 15.12, respectively. There was a significant deterioration in the Bhalla score (p < 0.01) and in certain categories: severity of bronchiectasis, peribronchial thickening, mucous plugging and bronchial divisions. Females had a more pronounced worsening of the Bhalla score than males (p = 0.048). No change over time was found in FEV1 and FVC. Only sex was associated with a deterioration in HRCT.


CONCLUSIONS
HRCT Bhalla scoring changes statistically significantly over 4 years, but spirometry results do not. Worsening on HRCT is more evident in females.


KEY POINTS
• HRCT Bhalla scoring changes significantly over 4 years, spirometry results do not. • Females experience faster respiratory deterioration than males. • Spirometry results are not associated with deterioration in HRCT.
['Carpio|Carlos|C|', 'Albi|Gustavo|G|', 'Rayón-Aledo|José Carlos|JC|', 'Álvarez-Sala|Rodolfo|R|', 'Girón|Rosa|R|', 'Prados|Concepción|C|', 'Caballero|Paloma|P|']
D000293:Adolescent D001987:Bronchiectasis D002648:Child D003550:Cystic Fibrosis D005260:Female D005500:Follow-Up Studies D005541:Forced Expiratory Volume D006801:Humans D008168:Lung D008297:Male D011446:Prospective Studies D012720:Severity of Illness Index D013147:Spirometry D014057:Tomography, X-Ray Computed
Cystic fibrosis Computed tomography Spirometry Bronchiectasis Thoracic radiography X-ray