Tracheomalacia in adults with cystic fibrosis: determination of prevalence and severity with dynamic cine CT.

Hdl Handle:
http://hdl.handle.net/10147/207555
Title:
Tracheomalacia in adults with cystic fibrosis: determination of prevalence and severity with dynamic cine CT.
Authors:
McDermott, Shaunagh; Barry, Sinead C; Judge, Eoin E; Collins, Susan; de Jong, Pim A; Tiddens, Harm A W M; McKone, Edward F; Gallagher, Charles C; Dodd, Jonathan D
Affiliation:
Department of Radiology, St Vincent's University Hospital, Elm Park, Dublin 4,, Ireland.
Citation:
Radiology. 2009 Aug;252(2):577-86. Epub 2009 Jun 9.
Journal:
Radiology
Issue Date:
1-Feb-2012
URI:
http://hdl.handle.net/10147/207555
DOI:
10.1148/radiol.2522081956
PubMed ID:
19508990
Abstract:
PURPOSE: To determine the prevalence and severity of tracheomalacia in adults with cystic fibrosis (CF) by using dynamic cine multidetector computed tomography (CT) and to correlate these findings with pulmonary function test (PFT) results and the severity of parenchymal lung disease. MATERIALS AND METHODS: In this institutional review board-approved HIPAA-compliant study, 40 patients with CF (22 men, 18 women; mean age, 28 years +/- 8 [standard deviation]; age range, 18-54 years) prospectively underwent PFTs, standard thin-section CT, and two dynamic cine multidetector CT acquisitions. Ten control subjects underwent dynamic cine multidetector CT. After standard thin-section CT was completed, dynamic cine multidetector CT was performed during a forced expiratory maneuver and during coughing. Dynamic cine multidetector CT images in nine patients were excluded. Maximal inspiratory, dynamic expiratory, and end-expiratory tracheal luminal areas were compared (Student t test) and correlated (Spearman rank) with PFT results and severity of parenchymal lung disease. RESULTS: Mean predicted forced expiratory volume in 1 second (FEV(1)) was 70.6% +/- 20.7, and mean Bhalla CT score was 41.8% +/- 13.6. In patients with CF, dynamic cine mean tracheal cross-sectional area reduction was 51.7% +/- 18.4 (range, 9%-89%) for forced expiratory maneuvers and 68.8% +/- 11.7 (range, 18%-88%) for coughing (P = .001). Tracheomalacia was demonstrated in 24 (69%) patients and no control subjects during forced expiratory maneuvers (P = .001) and in 10 (29%) patients and one (10%) control subject during coughing. For end-expiration images, mean tracheal luminal reduction was 16.1% +/- 14.0% (range, 0.0%-53.0%), with one patient demonstrating tracheal luminal reduction of more than 50%. There was no correlation between tracheal cross-sectional luminal reduction and either predicted FEV(1) or CT Bhalla score. CONCLUSION: Tracheomalacia depicted at dynamic cine multidetector CT is a highly prevalent finding in adults with CF. SUPPLEMENTAL MATERIAL: http://radiology.rsnajnls.org/cgi/content/full/2522081956/DC1.
Language:
eng
MeSH:
Adolescent; Adult; Cystic Fibrosis/*complications/*radiography; Humans; Male; Prevalence; Reproducibility of Results; Sensitivity and Specificity; Tomography, X-Ray Computed/*methods; Tracheomalacia/*complications/*radiography; Young Adult
ISSN:
1527-1315 (Electronic); 0033-8419 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorMcDermott, Shaunaghen_GB
dc.contributor.authorBarry, Sinead Cen_GB
dc.contributor.authorJudge, Eoin Een_GB
dc.contributor.authorCollins, Susanen_GB
dc.contributor.authorde Jong, Pim Aen_GB
dc.contributor.authorTiddens, Harm A W Men_GB
dc.contributor.authorMcKone, Edward Fen_GB
dc.contributor.authorGallagher, Charles Cen_GB
dc.contributor.authorDodd, Jonathan Den_GB
dc.date.accessioned2012-02-01T10:31:12Z-
dc.date.available2012-02-01T10:31:12Z-
dc.date.issued2012-02-01T10:31:12Z-
dc.identifier.citationRadiology. 2009 Aug;252(2):577-86. Epub 2009 Jun 9.en_GB
dc.identifier.issn1527-1315 (Electronic)en_GB
dc.identifier.issn0033-8419 (Linking)en_GB
dc.identifier.pmid19508990en_GB
dc.identifier.doi10.1148/radiol.2522081956en_GB
dc.identifier.urihttp://hdl.handle.net/10147/207555-
dc.description.abstractPURPOSE: To determine the prevalence and severity of tracheomalacia in adults with cystic fibrosis (CF) by using dynamic cine multidetector computed tomography (CT) and to correlate these findings with pulmonary function test (PFT) results and the severity of parenchymal lung disease. MATERIALS AND METHODS: In this institutional review board-approved HIPAA-compliant study, 40 patients with CF (22 men, 18 women; mean age, 28 years +/- 8 [standard deviation]; age range, 18-54 years) prospectively underwent PFTs, standard thin-section CT, and two dynamic cine multidetector CT acquisitions. Ten control subjects underwent dynamic cine multidetector CT. After standard thin-section CT was completed, dynamic cine multidetector CT was performed during a forced expiratory maneuver and during coughing. Dynamic cine multidetector CT images in nine patients were excluded. Maximal inspiratory, dynamic expiratory, and end-expiratory tracheal luminal areas were compared (Student t test) and correlated (Spearman rank) with PFT results and severity of parenchymal lung disease. RESULTS: Mean predicted forced expiratory volume in 1 second (FEV(1)) was 70.6% +/- 20.7, and mean Bhalla CT score was 41.8% +/- 13.6. In patients with CF, dynamic cine mean tracheal cross-sectional area reduction was 51.7% +/- 18.4 (range, 9%-89%) for forced expiratory maneuvers and 68.8% +/- 11.7 (range, 18%-88%) for coughing (P = .001). Tracheomalacia was demonstrated in 24 (69%) patients and no control subjects during forced expiratory maneuvers (P = .001) and in 10 (29%) patients and one (10%) control subject during coughing. For end-expiration images, mean tracheal luminal reduction was 16.1% +/- 14.0% (range, 0.0%-53.0%), with one patient demonstrating tracheal luminal reduction of more than 50%. There was no correlation between tracheal cross-sectional luminal reduction and either predicted FEV(1) or CT Bhalla score. CONCLUSION: Tracheomalacia depicted at dynamic cine multidetector CT is a highly prevalent finding in adults with CF. SUPPLEMENTAL MATERIAL: http://radiology.rsnajnls.org/cgi/content/full/2522081956/DC1.en_GB
dc.language.isoengen_GB
dc.subject.meshAdolescenten_GB
dc.subject.meshAdulten_GB
dc.subject.meshCystic Fibrosis/*complications/*radiographyen_GB
dc.subject.meshHumansen_GB
dc.subject.meshMaleen_GB
dc.subject.meshPrevalenceen_GB
dc.subject.meshReproducibility of Resultsen_GB
dc.subject.meshSensitivity and Specificityen_GB
dc.subject.meshTomography, X-Ray Computed/*methodsen_GB
dc.subject.meshTracheomalacia/*complications/*radiographyen_GB
dc.subject.meshYoung Adulten_GB
dc.titleTracheomalacia in adults with cystic fibrosis: determination of prevalence and severity with dynamic cine CT.en_GB
dc.contributor.departmentDepartment of Radiology, St Vincent's University Hospital, Elm Park, Dublin 4,, Ireland.en_GB
dc.identifier.journalRadiologyen_GB
dc.description.provinceLeinster-

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