A New Scoring System for Computed Tomography of the Chest for Assessing the Clinical Status of Bronchopulmonary Dysplasia
Received 12 December 2006; received in revised form 6 April 2007; accepted 25 May 2007. published online 22 October 2007.
Objective
To develop a new scoring system for computed tomography (CT) of the chest for assessing the clinical status of patients with bronchopulmonary dysplasia (BPD) in comparison with a modified Edwards roentgenographic scoring system.
Study design
Preterm infants diagnosed with BPD (n = 42) were assessed prospectively by chest CT scan at the time of discharge. Three radiologists classified the CT findings into 1 of 3 categories—hyperexpansion, emphysema, or fibrous/interstitial abnormalities—and developed a new scoring system. We assessed interobserver reproducibility and investigated whether this classification system reflected the severity of BPD in these patients.
Results
The CT scores had acceptable reproducibility (coefficient of correlation [cc] = 0.721 to 0.839). The subgroup with a more severe form of BPD had a higher CT score. The CT score correlated with the clinical score at 36 weeks of postmenstrual age (cc = 0.367) and the duration of oxygen therapy (cc = 0.537). Patients who were discharged home on oxygen had higher CT scores than patients who were not.
Conclusions
The new chest CT scoring system may have higher objectivity and accuracy in terms of predischarge assessment of clinical status as well as prediction of the prognosis of patients with BPD.
aDepartment of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
bDepartment of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
cPerinatal and Maternity Care Unit, Kyushu University Hospital, Fukuoka, Japan
dDepartment of Neonatology, Fukuoka Municipal Children’s Hospital and Medical Center for Infectious Disease, Fukuoka, Japan
eDepartment of Pediatrics, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan.
Reprint requests: Masayuki Ochiai, MD, Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
ABSTRACT