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High-Resolution CT of the Chest in Children and Young Adults Who Were Born Prematurely: Findings in a Population-Based Study

¹ Department of Radiology, Section of Paediatrics, Haukeland University Hospital, 5021 Bergen, Norway.
² Department of Paediatrics, Haukeland University Hospital, Bergen, Norway.
³ Department of Public Health and Primary Health Care, and Medical Birth Registry of Norway, Section for Epidemiology and Medical Statistics, University of Bergen, Bergen, Norway.

OBJECTIVE. The purpose of this study was to use a scoring system for high-resolution CT in the evaluation of radiologic findings in young people born extremely preterm and to examine the reproducibility of this scoring system.

SUBJECTS AND METHODS. High-resolution CT of the lungs was assessed in 72 children born at a gestational age of 28 weeks or with a birth weight of 1,000 g within a defined region in western Norway in 1982-1985 (n = 40) or in 1991-1992 (n = 32). All images were analyzed by two pediatric radiologists using a scoring system in which a total of 14 features were assessed.

RESULTS. Sixty-three (88%) of the subjects had abnormal findings, the most common being linear opacities (n = 52), triangular opacities (n = 42), air trapping (n = 19), and mosaic perfusion (n = 10). Right and left lungs were equally affected. There were fewer abnormalities in the younger age group (born in 1991-1992). Intraobserver agreement and interobserver agreement were moderate (weighted = 0.54 and = 0.52, respectively). Fifty-six of the 72 children had a clinical diagnosis of bronchopulmonary dysplasia, and the median total score and the median scores of the four most common findings were higher in the bronchopulmonary dysplasia group; however, the differences were not statistically significant.

CONCLUSION. High-resolution CT in young people of preterm birth revealed abnormal radiologic findings in 81.3% of the patients at age 10 years and 92.5% at age 18 years. Linear, triangular, and subpleural opacities were the most common. The reproducibility of the applied scoring system was acceptable.

Keywords: bronchopulmonary dyplasia • high-resolution CT • lung disease • neonatal imaging • pediatric radiology

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