A new scoring system for computed tomography of the chest for assessing the clinical status of bronchopulmonary dysplasia

J Pediatr. 2008 Jan;152(1):90-5, 95.e1-3. doi: 10.1016/j.jpeds.2007.05.043. Epub 2007 Oct 22.

Abstract

Objective: To develop a new scoring system for computed tomography (CT) of the chest for assessing the clinical status of patients with bronchopulmonary dysplasia (BPD) in comparison with a modified Edwards roentgenographic scoring system.

Study design: Preterm infants diagnosed with BPD (n = 42) were assessed prospectively by chest CT scan at the time of discharge. Three radiologists classified the CT findings into 1 of 3 categories--hyperexpansion, emphysema, or fibrous/interstitial abnormalities--and developed a new scoring system. We assessed interobserver reproducibility and investigated whether this classification system reflected the severity of BPD in these patients.

Results: The CT scores had acceptable reproducibility (coefficient of correlation [cc] = 0.721 to 0.839). The subgroup with a more severe form of BPD had a higher CT score. The CT score correlated with the clinical score at 36 weeks of postmenstrual age (cc = 0.367) and the duration of oxygen therapy (cc = 0.537). Patients who were discharged home on oxygen had higher CT scores than patients who were not.

Conclusions: The new chest CT scoring system may have higher objectivity and accuracy in terms of predischarge assessment of clinical status as well as prediction of the prognosis of patients with BPD.

Publication types

  • Comparative Study

MeSH terms

  • Bronchopulmonary Dysplasia / diagnostic imaging*
  • Bronchopulmonary Dysplasia / pathology
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Infant, Premature*
  • Male
  • Multivariate Analysis
  • Observer Variation
  • Predictive Value of Tests
  • Prognosis
  • Prospective Studies
  • Reproducibility of Results
  • Severity of Illness Index
  • Tomography, X-Ray Computed*