Ochiai Masayuki, Hikino Shunji, Yabuuchi Hidetake, Nakayama Hideki, Sato Kazuo, Ohga Shouichi, Hara Toshiro
Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
J Pediatr. 2008 Jan;152(1):90-5, 95.e1-3. doi: 10.1016/j.jpeds.2007.05.043. Epub 2007 Oct 22.
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.
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.
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.
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.
开发一种用于胸部计算机断层扫描（CT）的新评分系统，以评估支气管肺发育不良（BPD）患者的临床状况，并与改良的爱德华兹X线评分系统进行比较。
对42例诊断为BPD的早产儿在出院时进行前瞻性胸部CT扫描评估。三名放射科医生将CT表现分为三类中的一类——肺过度膨胀、肺气肿或纤维/间质异常——并开发了一种新的评分系统。我们评估了观察者间的可重复性，并研究了该分类系统是否反映了这些患者BPD的严重程度。
CT评分具有可接受的可重复性（相关系数[cc]=0.721至0.839）。BPD更严重形式的亚组CT评分更高。CT评分与月经后36周时的临床评分（cc=0.367）和氧疗持续时间（cc=0.537）相关。出院时仍需吸氧的患者CT评分高于无需吸氧的患者。
新的胸部CT评分系统在BPD患者出院前临床状况评估以及预后预测方面可能具有更高的客观性和准确性。
