Department of Respiratory Medicine, University Hospital La Paz, La Paz Hospital Research Institute, Paseo de la Castellana, 261, 28046, Madrid, Spain.
Department of Radiology, Niño de Jesús Children's Hospital, Madrid, Spain.
Eur Radiol. 2015 Dec;25(12):3577-85. doi: 10.1007/s00330-015-3782-4. Epub 2015 May 1.
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.
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.
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.
HRCT Bhalla scoring changes statistically significantly over 4 years, but spirometry results do not. Worsening on HRCT is more evident in females.
• 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.
比较高分辨率计算机断层扫描（HRCT）显示的肺部结构病变进展与囊性纤维化（CF）患者肺功能检查结果变化的关系，并分析与肺部结构病变随时间恶化相关的因素。
前瞻性纳入 31 例 CF 患者（平均年龄 11.03±3.67 岁），相隔 4 年进行两次 HRCT 和肺功能检查。采用 Bhalla 评分系统对 HRCT 异常进行评分。对所有患者以及按年龄、性别、基因型改变和肺阻塞分类的组进行 HRCT 和肺功能检查变化的比较。
平均 HRCT Bhalla 评分、1 秒用力呼气容积占预计值百分比（FEV1%pred.）和用力肺活量占预计值百分比（FVC%pred.）分别为 7.92±3.59、87.76±20.52 和 96.54±15.12。Bhalla 评分（p<0.01）和某些分类的评分显著恶化：支气管扩张严重程度、支气管周围增厚、黏液嵌塞和支气管分支。女性的 Bhalla 评分恶化程度比男性更明显（p=0.048）。FEV1 和 FVC 随时间无变化。只有性别与 HRCT 恶化有关。
HRCT Bhalla 评分在 4 年内有统计学意义的变化，但肺功能检查结果没有变化。HRCT 恶化在女性中更为明显。
• HRCT Bhalla 评分在 4 年内显著变化，肺功能检查结果无变化。• 女性比男性呼吸恶化更快。• 肺功能检查结果与 HRCT 恶化无关。
