Mahut Bruno, De Blic Jacques, Emond Sophie, Benoist Marie-Rose, Jarreau Pierre-Henri, Lacaze-Masmonteil Thierry, Magny Jean-François, Delacourt Christophe
Christophe Delacourt, Service de Pédiatrie, Centre Hospitalier Intercommunal, 40 avenue de Verdun, 94000 Créteil, France.
Arch Dis Child Fetal Neonatal Ed. 2007 Nov;92(6):F459-64. doi: 10.1136/adc.2006.111765. Epub 2007 Mar 22.
With changes in the predominant pathogenic factors in the new form of bronchopulmonary dysplasia (BPD), a different pattern of CT findings may be expected. This study aimed to (1) describe CT findings in infants with BPD and (2) correlate the CT findings with lung function abnormalities.
Retrospective review of 41 very low birthweight infants with BPD, who were referred for pulmonary investigations at between 10 and 20 months after birth because of persistent respiratory symptoms, and underwent CT and lung function tests.
None of the infants had normal CT findings. The most frequent abnormalities were hyperlucent areas (n = 36; 88%), linear opacities (n = 39; 95%), and triangular subpleural opacities (n = 26; 63%). Bronchiectasis was not seen. None of the CT abnormalities correlated with the maximum expiratory flow at functional residual capacity (VmaxFRC). In contrast, increased number of subpleural opacities and limited linear opacities were associated with low FRC and longer duration of neonatal oxygen exposure. The numbers of triangular subpleural opacities also correlated with duration of mechanical ventilation.
Despite advances in neonatal care, many CT findings in infants with BPD are similar to those observed in the pre-surfactant era, and are still associated with duration of supplemental oxygen and mechanical ventilation. The absence of bronchial involvement in the present study was the most striking difference from previous studies.
随着新型支气管肺发育不良（BPD）主要致病因素的变化，可能会出现不同的CT表现模式。本研究旨在（1）描述BPD婴儿的CT表现，以及（2）将CT表现与肺功能异常相关联。
对41例极低出生体重的BPD婴儿进行回顾性研究，这些婴儿因持续呼吸道症状于出生后10至20个月被转诊进行肺部检查，并接受了CT和肺功能测试。
所有婴儿的CT表现均不正常。最常见的异常为透亮区（n = 36；88%）、线状阴影（n = 39；95%）和胸膜下三角形阴影（n = 26；63%）。未见支气管扩张。CT异常均与功能残气量时的最大呼气流量（VmaxFRC）无关。相比之下，胸膜下阴影数量增加和线状阴影局限与功能残气量降低及新生儿吸氧时间延长相关。胸膜下三角形阴影数量也与机械通气时间相关。
尽管新生儿护理有所进步，但BPD婴儿的许多CT表现与表面活性剂时代之前观察到的相似，并且仍与吸氧和机械通气时间相关。本研究中未出现支气管受累情况，这是与以往研究最显著的差异。
