Diagnostic Accuracy of Thin-Section CT and Chest Radiography of Pediatric  Interstitial Lung Disease

Copley, Susan J.; Coren, ME; Nicholson, Andrew G.; Rubens, M B; Bush, Andrew; Hansell, David M.

doi:10.2214/ajr.174.2.1740549

Cited by 86 publications

(57 citation statements)

References 25 publications

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“…Consequently, the key chest imaging tool for the diagnosis and management of a patient with ILD is HRCT, which can visualise the parenchymal structure to the level of the secondary pulmonary lobule. Recent paediatric literature confirms that HRCT increases the level of diagnostic confidence for infiltrative lung disease [27][28][29][30][31][32]. HRCT has now been proven to be useful for ILD diagnosis in children, and for patient management by helping to select the lung area to be biopsied.…”

Section: Chest Imagingmentioning

confidence: 96%

“…In three, HRCT showed a predominantly upper-zone honeycomb pattern with parenchymal distortion superimposed on a background of widespread ground-glass opacification. As discussed in the adult ILD, the presence of ground-glass opacities without HRCT findings of fibrosis may be a marker of an active disease [29,30,[38][39][40]. However, HRCT still needs evaluation as a follow-up tool in paediatric patients.…”

Section: Chest Imagingmentioning

confidence: 99%

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Task force on chronic interstitial lung disease in immunocompetent children

2004

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Chronic interstitial lung diseases in children represent a heterogeneous group of disorders of both known and unknown causes that share common histological features. Despite many efforts these diseases continue to present clinical management dilemmas, principally because of their rare frequency that limits considerably the possibilities of collecting enough cases for clinical and research studies. Through a Task Force conducted by the European Respiratory Society, which comprised respiratory physicians and basic scientists from across Europe, 185 cases of interstitial lung diseases in immunocompetent children were collected and reviewed. The present report provides important clinically-relevant information on the current approach to diagnosis and management of chronic interstitial lung diseases in children. In addition, recommendations for the management of paediatric interstitial lung diseases, as well as new insights into interstitial lung diseases pathophysiology during childhood are discussed

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Section: Chest Imagingmentioning

confidence: 96%

Section: Chest Imagingmentioning

confidence: 99%

Task force on chronic interstitial lung disease in immunocompetent children

2004

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“…CXRs are usually the first imaging study performed in chILD syndrome. They rarely provide a specific chILD diagnosis, but they are frequently abnormal, and may identify diseases that mimic chILD syndrome (34,35). CT defines the presence, extent, and pattern of lung disease.…”

Section: Diagnostic Testsmentioning

confidence: 99%

“…The observations described here derive from two observational studies that found that CT scanning is more likely than CXR to accurately identify DLD in children (17,35), numerous case series that reported a strong correlation between histologic findings and the thin-section CT scan appearance in children with surfactant protein C mutation (42), neuroendocrine cell hyperplasia of infancy (NEHI) ( Figure 5) (20) and other DLDs (17,19,35), and two studies that demonstrated that CT scanning is superior to MRI in resolution and in identifying ground glass opacity, normal peripheral bronchi, and air trapping in patients with cystic fibrosis (43,44). Although cystic fibrosis is not a chILD disorder, resolution is an important determinant of image quality, and the findings of air trapping and ground glass opacity are key observations in chILD.…”

Section: Diagnostic Testsmentioning

confidence: 99%

An Official American Thoracic Society Clinical Practice Guideline: Classification, Evaluation, and Management of Childhood Interstitial Lung Disease in Infancy

Kurland¹,

Deterding²,

Hagood³

et al. 2013

Am J Respir Crit Care Med

395

499

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“…The chest radiograph is usually very non-specific and non-diagnostic [11]. There may be groundglass shadowing with prominent air bronchograms, or coarse nodular or reticularnodular shadowing; in advanced cases, honeycombing is seen.…”

Section: Imagingmentioning

confidence: 99%

Paediatric interstitial lung disease

Bush

2005

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Key pointsPresentation of ILD is very non-specific.Imaging, especially HRCT, confirms the presence of ILD, but is rarely diagnostic.Invasive diagnosis is almost always needed.Bronchoscopy rarely gives diagnostic information in paediatric ILD.For most paediatric ILD, transbronchial or percutaneous lung biopsy gives insufficient tissue for diagnosis and carries increased risk.Open lung biopsy or VATS is the diagnostic investigation of choice.Educational aimsTo allow the reader to correctly identify infants and children with interstitial lung disease (ILD).To help the reader to appreciate the wide differential diagnosis, including that of disorders specific to infancy, comprising the surfactant protein disorders.To explain the strengths and weaknesses of the different investigative modalities used in establishing a firm diagnosis.To discuss the limited evidence for the different treatment options currently in use.SummaryPaediatric interstitial disease is rare, and comprises many disparate diseases. This article aims to provide the reader with an update on how to recognise infants and children who should be considered as possibly having ILD. The diagnostic process, including the roles of HRCT and bronchoscopy, and the different methods of lung biopsy, will be set out. The newly recognised entities, such as neuroendocrine cell hyperplasia of infancy, pulmonary interstitial glycogenosis and the disorders of surfactant protein metabolism, are also described. Finally, the article reviews the evidence that exists to guide treatment of these conditions.

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Diagnostic Accuracy of Thin-Section CT and Chest Radiography of Pediatric Interstitial Lung Disease

Abstract: A higher proportion of pediatric interstitial lung diseases can be diagnosed on thin-section CT than on chest radiographs. In our study, confident and correct diagnoses were made more frequently with CT than with chest radiographs.

Cited by 86 publications

References 25 publications

Task force on chronic interstitial lung disease in immunocompetent children

Task force on chronic interstitial lung disease in immunocompetent children

An Official American Thoracic Society Clinical Practice Guideline: Classification, Evaluation, and Management of Childhood Interstitial Lung Disease in Infancy

Paediatric interstitial lung disease

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