Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Department of Radiology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
Pediatr Pulmonol. 2024 Sep;59(9):2276-2285. doi: 10.1002/ppul.26487. Epub 2023 May 24.
Interstitial and diffuse lung diseases in children constitute a range of congenital and acquired disorders. These disorders present with signs and symptoms of respiratory disease accompanied by diffuse radiographic changes. In many cases, radiographic findings are nonspecific, while in other disorders, chest computed tomography (CT) is diagnostic in the appropriate context. Regardless, chest imaging remains central in the evaluation of the patient with suspected childhood interstitial lung disease (chILD). Several newly described chILD entities, spanning both genetic and acquired etiologies, have imaging that aid in their diagnoses. Advances in CT scanning technology and CT analysis techniques continue to improve scan quality as well as expand use of chest CT as a research tool. Finally, ongoing research is expanding use of imaging modalities without ionizing radiation. Magnetic resonance imaging is being applied to investigate pulmonary structure and function, and ultrasound of the lung and pleura is a novel technique with an emerging role in chILD disorders. This review describes the current state of imaging in chILD including recently described diagnoses, advances in conventional imaging techniques and applications, and evolving new imaging modalities that expand the clinical and research roles for imaging in these disorders.
儿童间质性和弥漫性肺疾病构成了一系列先天性和获得性疾病。这些疾病表现为呼吸系统疾病的体征和症状,并伴有弥漫性放射学改变。在许多情况下,放射学表现是非特异性的,而在其他疾病中,胸部计算机断层扫描(CT)在适当的情况下具有诊断价值。无论如何,胸部成像仍然是疑似儿童间质性肺疾病(chILD)患者评估的核心。一些新描述的 chILD 实体,涵盖了遗传和获得性病因,其影像学表现有助于诊断。CT 扫描技术和 CT 分析技术的进步不断提高扫描质量,并扩大了胸部 CT 在研究工具中的应用。最后,正在进行的研究正在扩大无电离辐射成像方式的应用。磁共振成像(MRI)正被应用于研究肺结构和功能,而肺部和胸膜超声是一种新的技术,在 chILD 疾病中具有新兴的作用。本综述描述了 chILD 的影像学现状,包括最近描述的诊断、常规影像学技术的进步和应用,以及新兴的影像学方式,这些方式扩展了影像学在这些疾病中的临床和研究作用。