School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
Department of Pediatrics, Athens Medical Center, 5-7 Distomou str, 151 25, Marousi, Greece.
World J Pediatr. 2021 Jun;17(3):221-226. doi: 10.1007/s12519-020-00388-8. Epub 2021 May 25.
The timely and appropriate monitoring of pulmonary status is of utmost importance for patients with cystic fibrosis (CF). Computed tomography (CT) has been used in clinical and research settings for tracking lung involvement in CF patients. However, as CT delivers a considerable amount of radiation, its sequential use in CF patients remains a concern. The application of CT, therefore, should take into account its potential risks. This review aims to understand whether and to what extent the CT findings correlate with the findings from other monitoring tools in CF lung disease.
PubMed was searched for articles about the correlation of chest CT findings with spirometric indices and with lung clearance index in children and adolescents with CF. The most relevant articles were reviewed and are presented herein.
Most studies have shown that forced expiratory volume in the first second (FEV) and other spirometric indices correlate moderately with CT structural lung damage. However, at the individual level, there were patients with FEV within the normal range and abnormal CT and vice versa. Furthermore, longitudinal studies have indicated that the deterioration of structural lung damage does not occur in parallel with the progression of lung function. Lung clearance index is a better predictor of CT findings.
In general, the existing studies do not support the use of lung function tests as surrogates of chest CT.
对于囊性纤维化(CF)患者,及时、适当的肺部监测至关重要。计算机断层扫描(CT)已在临床和研究环境中用于跟踪 CF 患者的肺部受累情况。然而,由于 CT 会产生大量辐射,因此连续使用 CT 仍存在一定的顾虑。因此,CT 的应用应考虑到其潜在风险。本综述旨在了解 CT 检查结果与 CF 肺部疾病其他监测工具的结果之间是否存在关联,以及关联程度如何。
在 PubMed 上搜索了有关 CF 患儿和青少年的 CT 胸部发现与肺活量计指数以及肺清除指数相关性的文章。回顾了最相关的文章,并在此处呈现。
大多数研究表明,第一秒用力呼气量(FEV)和其他肺活量计指数与 CT 结构肺损伤中度相关。然而,在个体水平上,有 FEV 在正常范围内但 CT 异常的患者,反之亦然。此外,纵向研究表明,结构肺损伤的恶化与肺功能的进展并不平行。肺清除指数是 CT 发现的更好预测指标。
总的来说,现有研究不支持将肺功能测试作为 CT 胸部检查的替代指标。