Diagnosis of bronchiolitis obliterans with computed tomography in children

Simple item page
dc.contributor.authorSmith K.J.
dc.contributor.authorDishop M.K.
dc.contributor.authorFan L.L.
dc.contributor.authorMoonnumakal S.P.
dc.contributor.authorSmith E.O.
dc.contributor.authorBayindir P.
dc.contributor.authorGuillerman R.P.
dc.date.accessioned2024-07-22T08:20:35Z
dc.date.available2024-07-22T08:20:35Z
dc.date.issued2010
dc.description.abstractHistopathology has been considered the gold standard for diagnosis of bronchiolitis obliterans (BO). Although chest computed tomography (CT) has gained acceptance as an alternative tool for diagnosis, no systematic studies validating the diagnostic accuracy of chest CT have been performed in children with BO unrelated to transplantation. A study was undertaken to provide estimates of the strength of association between CT findings and the presence or absence of BO, and to determine if chest CT is predictive of lung biopsy results. In a single-center, retrospective, case-control study, 120 children who had both a chest CT and lung biopsy and no history of lung, heart-lung, or bone marrow transplant were included in this study. Chest CTs were scored for the presence or absence of 24 individual CT findings by a blinded subspecialty-trained pediatric radiologist. Lung biopsies were reviewed by a pediatric lung pathologist for the presence of airway fibrosis, which was classified as mild, moderate, or severe. Ten children had moderate-to-severe BO by lung biopsy. The presence of parenchymal hypoattenuation (P=0.003) and bronchiectasis (P=0.001) distinguished these patients from the remaining 110 patients who formed the control group. Combinations of findings improved specificity, and the combination of parenchymal hypoattenuation and vascular attenuation was highly specific (specificity 99.1%; positive likelihood ratio 22.2 and 44.4 for moderate and severe disease, respectively). However, the sensitivity of individual and combination findings was modest. In children with moderate or severe BO, a confident diagnosis can be made with a chest CT that has characteristic radiographic findings, thus avoiding the need for open lung biopsy. However, CT is not an effective screening tool for excluding BO. © 2010, Mary Ann Liebert, Inc. 2010.
dc.identifier.DOI-ID10.1089/ped.2010.0034
dc.identifier.issn21513228
dc.identifier.urihttp://akademikarsiv.cbu.edu.tr:4000/handle/123456789/18231
dc.language.isoEnglish
dc.subjectadolescent
dc.subjectarticle
dc.subjectbronchiectasis
dc.subjectbronchiolitis obliterans
dc.subjectcase control study
dc.subjectchild
dc.subjectcomputer assisted tomography
dc.subjectcontrolled study
dc.subjectdiagnostic test accuracy study
dc.subjectdisease severity
dc.subjectfemale
dc.subjecthistopathology
dc.subjecthuman
dc.subjecthuman tissue
dc.subjectlung parenchyma
dc.subjectmajor clinical study
dc.subjectmale
dc.subjectmedical specialist
dc.subjectopen lung biopsy
dc.subjectpediatrics
dc.subjectpredictive value
dc.subjectpreschool child
dc.subjectpriority journal
dc.subjectretrospective study
dc.subjectschool child
dc.subjectsensitivity and specificity
dc.subjectthorax radiography
dc.titleDiagnosis of bronchiolitis obliterans with computed tomography in children
dc.typeArticle

Files

Collections

Scopus Koleksiyonu