Newer Imaging Techniques for Bronchopulmonary Dysplasia

Walkup, Laura L.; Woods, Jason C.

doi:10.1016/j.clp.2015.08.012

Cited by 25 publications

(18 citation statements)

References 89 publications

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“…14 Efforts are now being made to design new low-dose CT scanning protocols and new radiological techniques, while emerging methods such as nonionizing, ultrashort echo time and hyperpolarized gas magnetic resonance imaging might prove good alternative options for the longitudinal assessment of these patients without any associated radiation risk. 15…”

Section: Abnormalities On Chest Radiologymentioning

confidence: 99%

Respiratory Outcome after Preterm Birth: A Long and Difficult Journey

et al. 2016

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Despite notable advances in the survival and management of preterm infants in recent decades, chronic lung disease remains a common complication. Approximately one in three infants born preterm (< 32 weeks of gestation) are hospitalized with respiratory problems (mainly due to infections) in their first 2 years of life, and the risk of childhood wheezing is three times higher in this population. By comparison with infants born at term, there seems to be a higher incidence of respiratory morbidity in those born preterm, even in the absence of bronchopulmonary dysplasia (BPD) and in late-preterm babies. Although long-term follow-up data are still not collected systematically, there is evidence of preterm infants' respiratory symptoms, lung function impairments, and radiological abnormalities, tending to persist throughout childhood and into early adulthood. Respiratory conditions associated with preterm birth are often diagnosed and treated as asthma, but the pathophysiological patterns of BPD and asthma are very different. Future research should focus on characterizing preterm infants' pathological pulmonary features by gestational age at birth, and presence or absence of BPD. Improving our current knowledge of the respiratory disorder associated with prematurity might hopefully prompt targeted follow-up protocols, and novel prevention strategies and treatment approaches.

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Section: Abnormalities On Chest Radiologymentioning

confidence: 99%

Respiratory Outcome after Preterm Birth: A Long and Difficult Journey

et al. 2016

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“…Lung pathology is variable and may include pulmonary vascular disease, tracheobronchomalacia, hyperinflation, patchy atelectasis, or cystic lesions, indicating that BPD is probably not a single disease [12]. However, a parenchymal component with loss of normal lung aeration is found in most patients with stablished BPD [19]. LUS has shown to be very sensitive in assessing lung aeration in different settings [20].…”

Section: Introductionmentioning

confidence: 99%

Early assessment of lung aeration using an ultrasound score as a biomarker of developing bronchopulmonary dysplasia: a prospective observational study

et al. 2020

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The objective of this study was to assess the predictive value of a lung ultrasound (LUS) score in the development of moderate-severe bronchopulmonary dysplasia (sBPD). This was a prospective observational diagnostic accuracy study in a third-level neonatal intensive care unit. Preterm infants with a gestational age below 32 weeks were included. A LUS score (range 0-24 points) was calculated by assessing aeration semiquantitatively (0-3 points) in eight lung zones on the 7th day of life (DOL) and repeated on the 28th DOL. ROC curves and logistic regression were used for analysis. Forty-two preterm infants were included. The LUS on the 7th DOL had an area under the receiver operating characteristic curve (AUROC) of 0.94 (95% CI: 0.87-1) for the prediction of sBPD (optimal cutoff of ≥8 points: sensitivity 93%, specificity 91%). The LUS score was independently associated with sBPD [OR 2.1 (95% CI: 1.1-3.9), p = 0.022, for each additional point in the score]. Conclusions: Lung aeration as assessed by LUS on the 7th DOL may predict the development of sBPD.

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“…Radiographic phenotypes on chest X‐ray have been proposed that include elements of fibrosis and hyperinflation, due to image opacities, lucencies, and ventilation inhomogeneity . This phenotype can be seen on standard chest radiographs in patients with severe cases of BPD and correlated with the severity of BPD, measured as a degree of oxygenation impairment . A qualitative scoring system including elements of hyperinflation, emphysema, fibrosis, and subjective impression of radiologists has been determined for X‐ray computed tomography (CT), the traditional gold standard of chest imaging.…”

Section: Introductionmentioning

confidence: 99%

Elevated lung volumes in neonates with bronchopulmonary dysplasia measured via MRI

Yoder

Higano

Schapiro

et al. 2019

Pediatric Pulmonology

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Background Bronchopulmonary dysplasia (BPD) is a chronic lung disease of prematurity defined by requirement for respiratory support at 36 weeks postmenstrual age (PMA), but structural sequelae like lung hyperinflation are often not quantified. Quiet‐breathing, nonsedated magnetic resonance imaging (MRI) allows tomographic quantification of lung volumes and densities. We hypothesized that functional residual capacity (FRC) and intrapleural volume (IV) are increased in BPD and correlate with qualitative radiological scoring of hyperinflation. Methods Ultrashort echo time (UTE) MRI of 17 neonates (acquired at ~39 weeks PMA) were reconstructed at end‐expiration and end‐inspiration via the time course of the k0 point in k‐space. Images were segmented to determine total lung, tidal, parenchymal tissue, and vascular tissue volumes. FRC was calculated by subtracting parenchymal and vascular tissue volumes from IV. Respiratory rate (RR) was calculated via the UTE respiratory waveform, yielding estimates of minute ventilation when combined with tidal volumes (TVs). Two radiologists scored hyperinflation on the MR images. Results IV at FRC increased in BPD: for control, mild, and severe (patients the median volumes were 32.8, 33.5, and 50.9 mL/kg, respectively. TV (medians: 2.21, 3.64, and 4.84 mL/kg) and minute ventilation (medians: 493, 750, and 991 mL/min) increased with increasing severity of BPD (despite decreasing RR, medians: 75.6, 63.0, and 56.1 breaths/min). FRC increased with increasing severity of BPD (39.3, 38.3, and 56.0 mL, respectively). Findings were consistent with increased hyperinflation scored by radiologists. Conclusions This study demonstrates that UTE MRI can quantify hyperinflation in neonatal BPD and that lung volumes significantly increase with disease severity.

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Newer Imaging Techniques for Bronchopulmonary Dysplasia

Cited by 25 publications

References 89 publications

Respiratory Outcome after Preterm Birth: A Long and Difficult Journey

Respiratory Outcome after Preterm Birth: A Long and Difficult Journey

Early assessment of lung aeration using an ultrasound score as a biomarker of developing bronchopulmonary dysplasia: a prospective observational study

Elevated lung volumes in neonates with bronchopulmonary dysplasia measured via MRI

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