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KMID : 0880420130140020350
Korean Journal of Radiology
2013 Volume.14 No. 2 p.350 ~ p.360
Bronchopulmonary Dysplasia: New High Resolution Computed Tomography Scoring System and Correlation between the High Resolution Computed Tomography Score and Clinical Severity
Shin Su-Mi

Kim Woo-Sun
Cheon Jung-Eun
Kim Han-Suk
Lee Whal
Jung Ah-Young
Kim In-One
Choi Jung-Hwan
Abstract
Objective: To develop an high resolution computed tomography (HRCT) scoring system for the assessment of bronchopulmonary dysplasia (BPD) and determine its usefulness as compared with the chest radiographic score.

Materials and Methods: Forty-two very low-birth-weight preterm infants with BPD (25 male, 17 female) were prospectively evaluated with HRCT performed at the mean age of 39.1-week postmenstrual age. Clinical severity of BPD was categorized as mild, moderate or severe. The HRCT score (0-36) of each patient was the sum of the number of bronchopulmonary segments with 1) hyperaeration and 2) parenchymal lesions (linear lesions, segmental atelectasis, consolidation and architectural distortion), respectively. We compared the HRCT scores with the chest radiographic scores (the Toce system) in terms of correlation with clinical severity.

Results: The HRCT score had good interobserver (r = 0.969, p < 0.001) and intraobserver (r = 0.986, p < 0.001) reproducibility. The HRCT score showed better correlation (r = 0.646, p < 0.001) with the clinical severity of BPD than the chest radiographic score (r = 0.410, p = 0.007). The hyperaeration score showed better correlation (r = 0.738, p < 0.001) with the clinical severity of BPD than the parenchymal score (r = 0.523, p < 0.001).

Conclusion: We have developed a new HRCT scoring system for BPD based on the quantitative evaluation of pulmonary abnormalities of BPD consisting of the hyperaeration score and the parenchymal score. The HRCT score shows better correlation with the clinical severity of BPD than the radiographic score.
KEYWORD
Bronchopulmonary dysplasia, Scoring system, HRCT, Chest radiography, Preterm infants
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