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Chest computed tomography findings in bronchopulmonary dysplasia and correlation with lung function

¹ Service de Pneumologie et Allergologie Pédiatriques, Necker-Enfants Malades, Paris, France
² Service de Radiologie Pédiatrique, Necker Enfants Malades, Paris, France
³ Service de Réanimation Néonatale, Cochin-Port Royal, Paris, France
⁴ Service de Réanimation Néonatale, Antoine Béclère, Clamart, France
⁵ Service de Réanimation Néonatale, Institut de Puériculture, Paris, France
⁶ Service de Pédiatrie and INSERM U841, Créteil, France

Correspondence to:
Christophe Delacourt, Service de Pédiatrie, Centre Hospitalier Intercommunal, 40 avenue de Verdun, 94000 Créteil, France; christophe.delacourt{at}chicreteil.fr

Objective: With changes in the predominant pathogenic factors in the new form of bronchopulmonary dysplasia (BPD), a different pattern of CT findings may be expected. This study aimed to (1) describe CT findings in infants with BPD and (2) correlate the CT findings with lung function abnormalities.

Study design and method: Retrospective review of 41 very low birthweight infants with BPD, who were referred for pulmonary investigations at between 10 and 20 months after birth because of persistent respiratory symptoms, and underwent CT and lung function tests.

Results: None of the infants had normal CT findings. The most frequent abnormalities were hyperlucent areas (n = 36; 88%), linear opacities (n = 39; 95%), and triangular subpleural opacities (n = 26; 63%). Bronchiectasis was not seen. None of the CT abnormalities correlated with the maximum expiratory flow at functional residual capacity (VmaxFRC). In contrast, increased number of subpleural opacities and limited linear opacities were associated with low FRC and longer duration of neonatal oxygen exposure. The numbers of triangular subpleural opacities also correlated with duration of mechanical ventilation.

Conclusions: Despite advances in neonatal care, many CT findings in infants with BPD are similar to those observed in the pre-surfactant era, and are still associated with duration of supplemental oxygen and mechanical ventilation. The absence of bronchial involvement in the present study was the most striking difference from previous studies.

Abbreviations: BPD, bronchopulmonary dysplasia; CT, computed tomography; PMA, postmenstrual age; VmaxFRC, maximum expiratory flow at functional residual capacity

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