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Radiological and functional changes over 3 years in young children with cystic fibrosis

Dept of Paediatric Pulmonology, University Medical Centre Utrecht, Utrecht, The Netherlands.

CORRESPONDENCE: S. W. J. Terheggen-Lagro, Dept of Paediatric Pulmonology, University Medical Centre Utrecht, Wilhelmina Children's Hospital, Internal Postal Code KH 01.419.0, P.O. Box 85090, 3508 AB Utrecht, The Netherlands. Fax: 31 302504747. E-mail: s.terheggen{at}umcutrecht.nl

Keywords: Chest radiograph scores, cystic fibrosis, interrupter resistance, preschool children

Received: April 13, 2006
Accepted April 7, 2007

The aim of the present study was to evaluate airway disease progression assessed by chest radiology, expiratory interrupter resistance (R_int,exp) and spirometry in young children with cystic fibrosis (CF) over a 3-yr period.

Two chest radiographs combined with two R_int,exp measurements were performed with a 3-yr interval in 21 preschool children (age (mean±SD) 3.2±0.9 yrs) and 30 schoolchildren with CF (age 7.2±1.9 yrs). Chest radiographs were scored using five different CF scoring systems and R_int,exp measurements were expressed as height-adjusted Z-scores. Spirometry was assessed in schoolchildren and the results were expressed as a percentage of predicted values.

Chest radiograph scores worsened significantly over the 3-yr period and a tendency towards more pronounced changes was observed, especially for the Wisconsin score, in preschool children. Most preschool and schoolchildren had R_int,exp Z-scores within the normal range at start and follow-up, and the annual change in R_int,exp Z-score was not significant. In schoolchildren, only the forced expiratory volume in one second as a percentage of forced vital capacity declined significantly during the study period.

In summary, in young children with cystic fibrosis, chest radiograph scores worsen significantly over time even while lung function remains stable.