Kistik fibrozisli çocuklarda toraks bilgisayarlı tomografi bulgularının klinik bulgular ile korelasyonunun değerlendirilmesi

Year 2019, Volume: 33 Issue: 3, 235 - 244, 06.02.2020

Fatma Sarıoğlu Seda Şirin Handan Güleryüz Suna Asilsoy

https://doi.org/10.5505/deutfd.2019.93898

Abstract

Amaç: Çalışmamızın amacı kistik fibrozisli çocuklarda toraks bilgisayarlı tomografi (BT) bulgularının klinik bulgular ile korelasyonunu araştırmaktır.
Gereç ve Yöntem: Hastanemizin Çocuk Sağlığı ve Hastalıkları Anabilim Dalı arşivi 2005-2019 yılları arasında izlenen kistik fibrozis (KF) hastalarını saptamak amacıyla retrospektif olarak tarandı. Kistik fibrozis tanısı almış, 0-18 yaş arasındaki 49 hastanın toraks BT görüntüleri retrospektif olarak değerlendirildi. BT’de bronşiektazi, peribronşial kalınlaşma, mukus tıkacı, sakkülasyon, abse, bül, amfizem, kollaps ve konsolidasyon varlığı değerlendirildi. Hastaların BT bulguları ile Bhalla skorlamasına göre puan elde edildi. Hastaların yaş, cinsiyet, vücut ağırlığı, boy, vücut kitle indeksi ve kültür sonuçları arşiv kayıt sisteminden kaydedildi. Ayrıca 49 hastanın 35 tanesinin solunum fonksiyon testi sonuçları kaydedildi. İstatistiksel analiz için korelasyon testleri uygulandı ve p değerinin 0,05’in altında olması anlamlı kabul edildi.
Bulgular: Kırk dokuz hastanın (24 erkek, 25 kız) yaşları 1-17 (ortalama 9,33±4,82) arasındaydı. BT’de en sık bulgular sırasıyla peribronşial kalınlaşma (%85,7), kollaps/konsolidasyon (%75,5) ve bronşiektazi (%73,4) idi. Hastaların FEV1 (p<0,001), FVC (p=0,002), FEV1/FVC (p=0,032) ve FEF25-75 (p=0,013) sonuçları ile BT skorları arasında negatif yönde korelasyon saptandı. Kültürde Pseudomonas aureginosa üremesi ile BT skoru arasında korelasyon bulundu (p<0,001). Ayrıca kültürde Pseudomonas aureginosa (p<0,001) ve/veya Staphylococcus aureus (p=0,001) üreyen hastaların BT skorları ile üremeyen hastaların BT skorları arasında anlamlı farklılık bulundu.
Sonuç: Kistik fibrozisli çocuklarda toraks BT bulguları, solunum fonksiyon testleri ve kültür sonuçlarıyla korelasyon göstermektedir. BT hastaların klinik takibinde önemli olup, Bhalla skoru KF hastalarını değerlendirmede kullanılabilecek skorlama yöntemidir.

Keywords

Kistik fibrozis, çocuk, bilgisayarlı tomografi, akciğer

THE ASSESSMENT OF THE CORRELATION BETWEEN THORAX COMPUTED TOMOGRAPHY AND CLINICAL FINDINGS IN CHILDREN WITH CYSTIC FIBROSIS

Abstract

Objective: The aim of this study is to evaluate the correlation between thorax computed tomography (CT) and clinical findings in children with cystic fibrosis.
Materials and Methods: The archive of our hospital between 2005 and 2019 was reviewed retrospectively. Forty-nine children with cystic fibrosis were included. By using thorax CT, bronchiectasis, peribronchial thickening, mucus plugging, sacculation, abscess, bulla, emphysema, collaps, and consolidation were evaluated retrospectively. The patients’ CT findings were scored according to Bhalla scoring system. The clinical findings of the children (age, sex, weight, height, body mass index, and the result of sputum or deep throat culture) were recorded. Respiratory function test results were also recorded in 35 of 49 patients who had been evaluated with spirometry. Correlation analysis was performed and a p value less than 0.05 was considered statistically significant.
Results: Forty-nine children (24 girls, 25 boys) were between 1-17 years (mean 9.33±4.82). The most common CT findings were peribronchial thickening (85.7%), collaps/consolidation (75.5%), and bronchiectasis (73.4%). There were significant correlations between the CT scores and FEV1 (p<0,001), FVC (p=0.002), FEV1/FVC (p=0.032), FEF25-75 (p=0.013), and Pseudomonas aureginosa growth in the culture (p<0.001). There was a significant difference in the CT scores between patients with Pseudomonas aureginosa (p<0.001) and/or Staphylococcus aureus (p=0.001) overgrowth and noovergrowth in the culture.
Conclusion: The thorax CT and clinical findings showed correlations in children with cystic fibrosis. Bhalla scoring system is a useful method to evaluate the cystic fibrosis patients in follow-up.

Keywords

Cystic fibrosis, pediatrics, computed tomography, lung

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