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Eur Respir J 2004; 23:93-97
Copyright ©ERS Journals Ltd 2004

Progressive damage on high resolution computed tomography despite stable lung function in cystic fibrosis

P.A. de Jong1, Y. Nakano2, M.H. Lequin3, J.R Mayo4, R. Woods2, P.D. Paré2 and H.A.W.M. Tiddens1

1 Dept of Paediatric Pulmonology and 2 Dept of Paediatric Radiology, Sophia Children's Hospital, Erasmus Medical Centre Rotterdam, Rotterdam, The Netherlands. 3 UBC McDonald Research Laboratories and iCAPTURE Centre, StPaul's Hospital, and 4 Dept of Radiology, Vancouver Hospital and Health Science Center, Vancouver, Canada

CORRESPONDENCE: H.A.W.M. Tiddens, Sophia Children's Hospital, Dept of Pediatric Pulmonology, Dr Molewaterplein 60, 3015 GJ, Rotterdam, The Netherlands. Fax: 31 104636801. E-mail: h.tiddens@erasmusmc.nl

Keywords: bronchiectasis, children, cystic fibrosis, high-resolution computed tomography, lung structure, pulmonary function test

Received: January 17, 2003
Accepted August 28, 2003

This work was supported in part by a grant from the NHL BI (HL64068-03). P.A. de Jongwas supported by a Gerrit Jan Mulder Stichting Fellowship (GJM-stichting, Erasmus Medical Centre, Rotterdam, The Netherlands).

For effective clinical management of cystic fibrosis (CF) lung disease it is important to closely monitor the start and progression of lung damage. The aim of this study was to investigate the ability of high-resolution computed tomography (HRCT) scoring systems and pulmonary function tests (PFT) to detect changes in lung disease.

CF children (n=48) had two HRCT scans in combination with two PFT 2 yrs apart. Their scans were scored using five scoring systems (Castile, Brody, Helbich, Santamaria and Bhalla). "Sensitivity" was defined as the ability to detect disease progression.

In this group of children, HRCT scores worsened. PFT remained unchanged or improved. Of the HRCT parameters, mucous plugging and the severity, extent and peripheral extension of bronchiectasis worsened significantly. Relationships between changes in HRCT scores and PFT were weak. Substantial structural lung damage was evident in some children who had normal lung function.

These data show that high-resolution computed tomography is more sensitive than pulmonary function tests in the detection of early and progressive lung disease, and suggest that high-resolution computed tomography may be useful in the follow up of cystic fibrosis children and as an outcome measure in studies that aim to reduce lung damage.




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