A Computed tomography scoring system to assess pulmonary disease among premature infants
| Autor(a) principal: | |
|---|---|
| Data de Publicação: | 2010 |
| Outros Autores: | , , , , , |
| Tipo de documento: | Artigo |
| Idioma: | eng |
| Título da fonte: | Repositório Institucional da FIOCRUZ (ARCA) |
| Texto Completo: | https://www.arca.fiocruz.br/handle/icict/1702 |
Resumo: | CONTEXTO E Objetivo: Tomografia computadorizada de alta resolução (TCAR) é considerada o melhor método para avaliação pulmonar detalhada. O objetivo foi descrever um sistema de escore baseado em alterações identificadas nas TCAR de lactentes prematuros e medir a validade preditiva do escore em relação à morbidade respiratória no primeiro ano de vida. TIPO DE ESTUDO E LOCAL: Estudo de coorte prospectiva no Instituto Fernandes Figueira, Fundação Oswaldo Cruz. Métodos: Sistema de escore baseado em alterações nas TCAR de lactentes prematuros. A área pulmonar alterada foi quantificada conforme o número de lobos alterados, acrescido do comprometimento pulmonar bilateral. Dois radiologistas aplicaram o escore em 86 TCAR. Foram analisadas as contabilidades intraobservador e interobservador e calculadas as propriedades do escore em relação à predição da morbidade respiratória no primeiro ano de vida. Resultados: A maioria (85%) dos pacientes apresentou TCAR anormal, e dentre estes, 56,2% apresentaram morbidade respiratória no primeiro ano de vida. Valores do escore variaram de zero a 12. Houve boa concordância entre os observadores (coeficiente de correlação intraclasse, CCI = 0,86, intervalo de confiança, IC: 0,64-0,83). Os valores preditivos do escore foram: valor preditivo positivo 81,8%, valor preditivo negativo 56,3%, sensibilidade 39,1% e especificidade 90,0%. Conclusão: O sistema de escore é reprodutível, de fácil aplicação e permite a comparação de TCAR de pacientes prematuros, identificando pacientes com maior probabilidade de morbidade respiratória no primeiro de vida. Seu uso permitirá a comparação de TC de lactentes prematuros com diferentes fatores de risco para morbidade respiratória. |
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Boechat, Márcia Cristina BastosMello, Rosane Reis deSilva, Kátia Silveira daDaltro, PedroMarchiori, EdsonRamos, Eloane GuimarãesDutra, Maria Virgínia Peixoto2011-03-21T17:30:46Z2011-03-21T17:30:46Z2010BOECHAT, Márcia Cristina Bastos et al. A computed tomography scoring system to assess pulmonary disease among premature infants. São Paulo, Med. J., São Paulo, v. 128, n. 6, p. 328-335, Dec. 2010.1806-9460https://www.arca.fiocruz.br/handle/icict/170210.1590/S1516-31802010000600004CONTEXTO E Objetivo: Tomografia computadorizada de alta resolução (TCAR) é considerada o melhor método para avaliação pulmonar detalhada. O objetivo foi descrever um sistema de escore baseado em alterações identificadas nas TCAR de lactentes prematuros e medir a validade preditiva do escore em relação à morbidade respiratória no primeiro ano de vida. TIPO DE ESTUDO E LOCAL: Estudo de coorte prospectiva no Instituto Fernandes Figueira, Fundação Oswaldo Cruz. Métodos: Sistema de escore baseado em alterações nas TCAR de lactentes prematuros. A área pulmonar alterada foi quantificada conforme o número de lobos alterados, acrescido do comprometimento pulmonar bilateral. Dois radiologistas aplicaram o escore em 86 TCAR. Foram analisadas as contabilidades intraobservador e interobservador e calculadas as propriedades do escore em relação à predição da morbidade respiratória no primeiro ano de vida. Resultados: A maioria (85%) dos pacientes apresentou TCAR anormal, e dentre estes, 56,2% apresentaram morbidade respiratória no primeiro ano de vida. Valores do escore variaram de zero a 12. Houve boa concordância entre os observadores (coeficiente de correlação intraclasse, CCI = 0,86, intervalo de confiança, IC: 0,64-0,83). Os valores preditivos do escore foram: valor preditivo positivo 81,8%, valor preditivo negativo 56,3%, sensibilidade 39,1% e especificidade 90,0%. Conclusão: O sistema de escore é reprodutível, de fácil aplicação e permite a comparação de TCAR de pacientes prematuros, identificando pacientes com maior probabilidade de morbidade respiratória no primeiro de vida. Seu uso permitirá a comparação de TC de lactentes prematuros com diferentes fatores de risco para morbidade respiratória.CONTEXT AND Objective: High-resolution computed tomography (HRCT) is considered to be the best method for detailed pulmonary evaluation. The aim here was to describe a scoring system based on abnormalities identified on HRCT among premature infants, and measure the predictive validity of the score in relation to respiratory morbidity during the first year of life. DESIGN AND SETTING: Prospective cohort study in Instituto Fernandes Figueira, Fundação Oswaldo Cruz. Methods: Scoring system based on HRCT abnormalities among premature newborns. The affected lung area was quantified according to the number of compromised lobes, in addition to bilateral pulmonary involvement. Two radiologists applied the score to 86 HRCT scans. Intraobserver and interobserver agreement were analyzed. The score properties were calculated in relation to predictions of respiratory morbidity during the first year of life. Results: Most of the patients (85%) presented abnormalities on HRCT, and among these, 56.2% presented respiratory morbidity during the first year of life. Scores ranged from zero to 12. There was good agreement between observers (intraclass correlation coefficient, ICC = 0.86, confidence interval, CI: 0.64-0.83). The predictive scores were as follows: positive predictive value 81.8%, negative predictive value 56.3%, sensitivity 39.1%, and specificity 90.0%. Conclusion: The scoring system is reproducible, easy to apply and allows HRCT comparisons among premature infants, by identifying patients with greater likelihood of respiratory morbidity during the first year of life. Its use will enable HRCT comparisons among premature infants with different risk factors for respiratory morbidity.Fundação Oswaldo Cruz. Instituto Fernandes Figueira. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Fernandes Figueira. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Fernandes Figueira. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Fernandes Figueira. Rio de Janeiro, RJ, Brasil.Universidade Federal Fluminense. Niterói, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Fernandes Figueira. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Fernandes Figueira. Rio de Janeiro, RJ, Brasil.eng1. Bancalari E, Claure N, Sosenko IR. Bronchopulmonary dysplasia: changes in pathogenesis, epidemiology and definition. Semin Neonatol. 2003;8(1):63-71. 2. de Mello RR, Dutra MV, Ramos JR, et al. Lung mechanics and high-resolution computed tomography of the chest in very low birth weight premature infants. Sao Paulo Med J. 2003;121(4):167-72. 3. Doyle LW, Faber B, Callanan C, et al. Bronchopulmonary dysplasia in very low birth weight subjects and lung function in late adolescence. Pediatrics. 2006;118(1):108-13. 4. Bhandari A, Panitch HB. Pulmonary outcomes in bronchopulmonary dysplasia. Semin Peri- natol. 2006;30(4):219-26. 5. de Mello RR, Dutra MV, Lopes JM. Morbidade respiratória no primeiro ano de vida de pre- maturos egressos de uma unidade pública de tratamento intensivo neonatal [Respiratory morbidity in the first year of life of preterm infants discharged from a neonatal intensive care unit]. J Pediatr (Rio J). 2004;80(6):503-10. 6. Aquino SL, Schechter MS, Chiles C, et al. High-resolution inspiratory and expiratory CT in older children and adults with bronchopulmonary dysplasia. AJR Am J Roentgenol. 1999;173(4):963-7. 7. Aukland SM, Halvorsen T, Fosse KR, Daltveit AK, Rosendahl K. High-resolution CT of the chest in children and young adults who were born prematurely: findings in a population-based study. AJR Am J Roentgenol. 2006;187(4):1012-8. 8. Mahut B, De Blic J, Emond S, et al. Chest computed tomography findings in bronchopul- monary dysplasia and correlation with lung function. Arch Dis Child Fetal Neonatal Ed. 2007;92(6):F459-64. 9. de Mello RR, Dutra MV, Ramos JR, et al. Neonatal risk factors for respiratory morbidity during the first year of life among premature infants. Sao Paulo Med J. 2006;124(2):77-84. 10. Oppenheim C, Mamou-Mani T, Sayegh N, et al. Bronchopulmonary dysplasia: value of CT in identifying pulmonary sequelae. AJR Am J Roentgenol. 1994;163(1):169-72. 11. Ochiai M, Hikino S, Yabuuchi H, et al. A new scoring system for computed tomography of the chest for assessing the clinical status of bronchopulmonary dysplasia. J Pediatr. 2008;152(1):90-5; 95.e1-3. 12. Edwards DK. Radiographic aspects of bronchopulmonary dysplasia. J Pediatr. 1979;95(5 Pt 2):823-9. 13. Greenough A, Kavvadia V, Johnson AH, et al. A simple chest radiograph score to predict chronic lung disease in prematurely born infants. Br J Radiol. 1999;72(858):530-3. 14. Toce SS, Farrel PM, Leavitt LA, Samuels DP, Edwards DK. Clinical and roentgenogra- phic scoring systems for assessing bronchopulmonary dysplasia. Am J Dis Child. 1984;138(6):581-5. 15. Weinstein MR, Peters ME, Sadek M, Palta M. A new radiographic scoring system for broncho- pulmonary dysplasia. Newborn Lung Project. Pediatr Pulmonol. 1994;18(5):284-9. 16. Yuksel B, Greenough A, Karani J, Page A. Chest radiograph scoring system for use in pre-term infants. Br J Radiol. 1991;64(767):1015-8. 17. Kubota J, Ohki Y, Inoue T, et al. Ultrafast CT scoring system for assessing bronchopulmonary dysplasia: reproducibility and clinical correlation. Radiat Med. 1998;16(3):167-74. 18. Brasfield D, Hicks G, Soong S, Tiller RE. The chest roentgenogram in cystic fibrosis: a new scoring system. Pediatrics. 1979;63(1):24-9. 19. Chrispin AR, Norman AP. The systematic evaluation of the chest radiograph in cystic fibrosis. Pediatr Radiol. 1974;2(2):101-5. 20. Koscik RE, Kosorok MR, Farrell PM, et al. Wisconsin cystic fibrosis chest radiograph scoring system: validation and standardization for application to longitudinal studies. Pediatr Pul- monol. 2000;29(6):457-67. 21. Weatherly MR, Palmer CG, Peters ME, et al. Wisconsin cystic fibrosis chest radiograph sco- ring system. Pediatrics. 1993;91(2):488-95. 22. Bhalla M, Turcios N, Aponte V, et al. Cystic fibrosis: scoring system with thin-section CT. Radiology. 1991;179(3):783-8. 23. Brody AS, Kosorok MR, Li Z, et al. Reproducibility of a scoring system for computed tomogra- phy scanning in cystic fibrosis. J Thorac Imaging. 2006;21(1):14-21. 24. Helbich TH, Heinz-Peer G, Eichler I, et al. Cystic fibrosis: CT assessment of lung involvement in children and adults. Radiology. 1999;213(2):537-44. 25. Maffessanti M, Candusso M, Brizzi F, Piovesana F. Cystic fibrosis in children: HRCT findings and distribution of disease. J Thorac Imaging. 1996;11(1):27-38. 26. Shah RM, Sexauer W, Ostrum BJ, Fiel SB, Friedman AC. High-resolution CT in the acute exa- cerbation of cystic fibrosis: evaluation of acute findings, reversibility of those findings, and clinical correlation. AJR Am J Roentgenol. 1997;169(2):375-80. 27. Webb WR, Muller NL, Naidich DP. High-resolution CT of the lung. 3rd ed. Philadelphia: Lippin- cott-Williams & Wilkins; 2001. 28. Lucaya J, Le Pointe. High-resolution CT of the lung in children - technique, indications, ana- tomy, features of lung disease, and clinical application. In: Lucaya J, Strife JL, editors. Pedia- tric chest imaging: chest imaging in infants and children. Berlin: Springer Verlag; 2002. p. 55-92. 29. Hansell DM, Bankier AA, MacMahon H, et al. Fleischner Society: glossary of terms for thora- cic imaging. Radiology. 2008;246(3):697-722. 30. Streiner DL. Learning how to differ: agreement and reliability statistics in psychiatry. Can J Psychiatry. 1995;40(2):60-6. 31. Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;1(8476):307-10. 32. Jobe AH, Bancalari E. Bronchopulmonary dysplasia. Am J Respir Crit Care Med. 2001;163(7):1723-9. 33. Lucaya J, Piqueras J, García-Peña P, et al. Low-dose high-resolution CT of the chest in chil- dren and young adults: dose, cooperation, artifact incidence, and image quality. AJR Am J Roentgenol. 2000;175(4):985-92.TomografiaTomografia Computadorizada por Raios XPrematuroPulmãoDisplasia BroncopulmonarTomographyTomography, X-ray ComputedInfant, PrematureLungBronchopulmonary DysplasiaDoenças do Prematuro - radiografiaPneumopatias - radiografiaTomografia Computadorizada por Raios X - métodosMétodos EpidemiológicosPrematuroDoenças do Prematuro - mortalidadeDoenças do Prematuro - patologiaPneumopatias - mortalidadePneumopatias - patologiaTomografia Computadorizada por Raios X - normasA Computed tomography scoring system to assess pulmonary disease among premature infantsUm sistema de escore por tomogra a computadorizada para avaliação da doença pulmonar em lactentes prematurosinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZORIGINALA computed tomography scoring system to assess pulmonary.pdfA computed tomography scoring system to assess pulmonary.pdfapplication/pdf323164https://www.arca.fiocruz.br/bitstream/icict/1702/1/A%20computed%20tomography%20scoring%20system%20to%20assess%20pulmonary.pdf83b27d373e9fb0ffde80f062316dab31MD51LICENSElicense.txtlicense.txttext/plain; charset=utf-81748https://www.arca.fiocruz.br/bitstream/icict/1702/2/license.txt8a4605be74aa9ea9d79846c1fba20a33MD52TEXTA computed tomography scoring system to assess pulmonary.pdf.txtA computed tomography scoring system to assess pulmonary.pdf.txtExtracted texttext/plain41222https://www.arca.fiocruz.br/bitstream/icict/1702/5/A%20computed%20tomography%20scoring%20system%20to%20assess%20pulmonary.pdf.txt3c108af48d4c727f87ee9a528dd70965MD55THUMBNAILA computed tomography scoring system to assess pulmonary.pdf.jpgA computed tomography scoring system to assess pulmonary.pdf.jpgGenerated Thumbnailimage/jpeg1768https://www.arca.fiocruz.br/bitstream/icict/1702/4/A%20computed%20tomography%20scoring%20system%20to%20assess%20pulmonary.pdf.jpga0141e072b939dfabfe6dd8bd0fdc2fbMD54icict/17022018-09-13 21:20:55.715oai:www.arca.fiocruz.br:icict/1702Tk9URTogUExBQ0UgWU9VUiBPV04gTElDRU5TRSBIRVJFClRoaXMgc2FtcGxlIGxpY2Vuc2UgaXMgcHJvdmlkZWQgZm9yIGluZm9ybWF0aW9uYWwgcHVycG9zZXMgb25seS4KCk5PTi1FWENMVVNJVkUgRElTVFJJQlVUSU9OIExJQ0VOU0UKCkJ5IHNpZ25pbmcgYW5kIHN1Ym1pdHRpbmcgdGhpcyBsaWNlbnNlLCB5b3UgKHRoZSBhdXRob3Iocykgb3IgY29weXJpZ2h0Cm93bmVyKSBncmFudHMgdG8gRFNwYWNlIFVuaXZlcnNpdHkgKERTVSkgdGhlIG5vbi1leGNsdXNpdmUgcmlnaHQgdG8gcmVwcm9kdWNlLAp0cmFuc2xhdGUgKGFzIGRlZmluZWQgYmVsb3cpLCBhbmQvb3IgZGlzdHJpYnV0ZSB5b3VyIHN1Ym1pc3Npb24gKGluY2x1ZGluZwp0aGUgYWJzdHJhY3QpIHdvcmxkd2lkZSBpbiBwcmludCBhbmQgZWxlY3Ryb25pYyBmb3JtYXQgYW5kIGluIGFueSBtZWRpdW0sCmluY2x1ZGluZyBidXQgbm90IGxpbWl0ZWQgdG8gYXVkaW8gb3IgdmlkZW8uCgpZb3UgYWdyZWUgdGhhdCBEU1UgbWF5LCB3aXRob3V0IGNoYW5naW5nIHRoZSBjb250ZW50LCB0cmFuc2xhdGUgdGhlCnN1Ym1pc3Npb24gdG8gYW55IG1lZGl1bSBvciBmb3JtYXQgZm9yIHRoZSBwdXJwb3NlIG9mIHByZXNlcnZhdGlvbi4KCllvdSBhbHNvIGFncmVlIHRoYXQgRFNVIG1heSBrZWVwIG1vcmUgdGhhbiBvbmUgY29weSBvZiB0aGlzIHN1Ym1pc3Npb24gZm9yCnB1cnBvc2VzIG9mIHNlY3VyaXR5LCBiYWNrLXVwIGFuZCBwcmVzZXJ2YXRpb24uCgpZb3UgcmVwcmVzZW50IHRoYXQgdGhlIHN1Ym1pc3Npb24gaXMgeW91ciBvcmlnaW5hbCB3b3JrLCBhbmQgdGhhdCB5b3UgaGF2ZQp0aGUgcmlnaHQgdG8gZ3JhbnQgdGhlIHJpZ2h0cyBjb250YWluZWQgaW4gdGhpcyBsaWNlbnNlLiBZb3UgYWxzbyByZXByZXNlbnQKdGhhdCB5b3VyIHN1Ym1pc3Npb24gZG9lcyBub3QsIHRvIHRoZSBiZXN0IG9mIHlvdXIga25vd2xlZGdlLCBpbmZyaW5nZSB1cG9uCmFueW9uZSdzIGNvcHlyaWdodC4KCklmIHRoZSBzdWJtaXNzaW9uIGNvbnRhaW5zIG1hdGVyaWFsIGZvciB3aGljaCB5b3UgZG8gbm90IGhvbGQgY29weXJpZ2h0LAp5b3UgcmVwcmVzZW50IHRoYXQgeW91IGhhdmUgb2J0YWluZWQgdGhlIHVucmVzdHJpY3RlZCBwZXJtaXNzaW9uIG9mIHRoZQpjb3B5cmlnaHQgb3duZXIgdG8gZ3JhbnQgRFNVIHRoZSByaWdodHMgcmVxdWlyZWQgYnkgdGhpcyBsaWNlbnNlLCBhbmQgdGhhdApzdWNoIHRoaXJkLXBhcnR5IG93bmVkIG1hdGVyaWFsIGlzIGNsZWFybHkgaWRlbnRpZmllZCBhbmQgYWNrbm93bGVkZ2VkCndpdGhpbiB0aGUgdGV4dCBvciBjb250ZW50IG9mIHRoZSBzdWJtaXNzaW9uLgoKSUYgVEhFIFNVQk1JU1NJT04gSVMgQkFTRUQgVVBPTiBXT1JLIFRIQVQgSEFTIEJFRU4gU1BPTlNPUkVEIE9SIFNVUFBPUlRFRApCWSBBTiBBR0VOQ1kgT1IgT1JHQU5JWkFUSU9OIE9USEVSIFRIQU4gRFNVLCBZT1UgUkVQUkVTRU5UIFRIQVQgWU9VIEhBVkUKRlVMRklMTEVEIEFOWSBSSUdIVCBPRiBSRVZJRVcgT1IgT1RIRVIgT0JMSUdBVElPTlMgUkVRVUlSRUQgQlkgU1VDSApDT05UUkFDVCBPUiBBR1JFRU1FTlQuCgpEU1Ugd2lsbCBjbGVhcmx5IGlkZW50aWZ5IHlvdXIgbmFtZShzKSBhcyB0aGUgYXV0aG9yKHMpIG9yIG93bmVyKHMpIG9mIHRoZQpzdWJtaXNzaW9uLCBhbmQgd2lsbCBub3QgbWFrZSBhbnkgYWx0ZXJhdGlvbiwgb3RoZXIgdGhhbiBhcyBhbGxvd2VkIGJ5IHRoaXMKbGljZW5zZSwgdG8geW91ciBzdWJtaXNzaW9uLgo=Repositório InstitucionalPUBhttps://www.arca.fiocruz.br/oai/requestrepositorio.arca@fiocruz.bropendoar:21352018-09-14T00:20:55Repositório Institucional da FIOCRUZ (ARCA) - Fundação Oswaldo Cruz (FIOCRUZ)false |
| dc.title.pt_BR.fl_str_mv |
A Computed tomography scoring system to assess pulmonary disease among premature infants |
| dc.title.alternative.pt_BR.fl_str_mv |
Um sistema de escore por tomogra a computadorizada para avaliação da doença pulmonar em lactentes prematuros |
| title |
A Computed tomography scoring system to assess pulmonary disease among premature infants |
| spellingShingle |
A Computed tomography scoring system to assess pulmonary disease among premature infants Boechat, Márcia Cristina Bastos Tomografia Tomografia Computadorizada por Raios X Prematuro Pulmão Displasia Broncopulmonar Tomography Tomography, X-ray Computed Infant, Premature Lung Bronchopulmonary Dysplasia Doenças do Prematuro - radiografia Pneumopatias - radiografia Tomografia Computadorizada por Raios X - métodos Métodos Epidemiológicos Prematuro Doenças do Prematuro - mortalidade Doenças do Prematuro - patologia Pneumopatias - mortalidade Pneumopatias - patologia Tomografia Computadorizada por Raios X - normas |
| title_short |
A Computed tomography scoring system to assess pulmonary disease among premature infants |
| title_full |
A Computed tomography scoring system to assess pulmonary disease among premature infants |
| title_fullStr |
A Computed tomography scoring system to assess pulmonary disease among premature infants |
| title_full_unstemmed |
A Computed tomography scoring system to assess pulmonary disease among premature infants |
| title_sort |
A Computed tomography scoring system to assess pulmonary disease among premature infants |
| author |
Boechat, Márcia Cristina Bastos |
| author_facet |
Boechat, Márcia Cristina Bastos Mello, Rosane Reis de Silva, Kátia Silveira da Daltro, Pedro Marchiori, Edson Ramos, Eloane Guimarães Dutra, Maria Virgínia Peixoto |
| author_role |
author |
| author2 |
Mello, Rosane Reis de Silva, Kátia Silveira da Daltro, Pedro Marchiori, Edson Ramos, Eloane Guimarães Dutra, Maria Virgínia Peixoto |
| author2_role |
author author author author author author |
| dc.contributor.author.fl_str_mv |
Boechat, Márcia Cristina Bastos Mello, Rosane Reis de Silva, Kátia Silveira da Daltro, Pedro Marchiori, Edson Ramos, Eloane Guimarães Dutra, Maria Virgínia Peixoto |
| dc.subject.other.pt_BR.fl_str_mv |
Tomografia Tomografia Computadorizada por Raios X Prematuro Pulmão Displasia Broncopulmonar |
| topic |
Tomografia Tomografia Computadorizada por Raios X Prematuro Pulmão Displasia Broncopulmonar Tomography Tomography, X-ray Computed Infant, Premature Lung Bronchopulmonary Dysplasia Doenças do Prematuro - radiografia Pneumopatias - radiografia Tomografia Computadorizada por Raios X - métodos Métodos Epidemiológicos Prematuro Doenças do Prematuro - mortalidade Doenças do Prematuro - patologia Pneumopatias - mortalidade Pneumopatias - patologia Tomografia Computadorizada por Raios X - normas |
| dc.subject.en.pt_BR.fl_str_mv |
Tomography Tomography, X-ray Computed Infant, Premature Lung Bronchopulmonary Dysplasia |
| dc.subject.decs.none.fl_str_mv |
Doenças do Prematuro - radiografia Pneumopatias - radiografia Tomografia Computadorizada por Raios X - métodos Métodos Epidemiológicos Prematuro Doenças do Prematuro - mortalidade Doenças do Prematuro - patologia Pneumopatias - mortalidade Pneumopatias - patologia Tomografia Computadorizada por Raios X - normas |
| description |
CONTEXTO E Objetivo: Tomografia computadorizada de alta resolução (TCAR) é considerada o melhor método para avaliação pulmonar detalhada. O objetivo foi descrever um sistema de escore baseado em alterações identificadas nas TCAR de lactentes prematuros e medir a validade preditiva do escore em relação à morbidade respiratória no primeiro ano de vida. TIPO DE ESTUDO E LOCAL: Estudo de coorte prospectiva no Instituto Fernandes Figueira, Fundação Oswaldo Cruz. Métodos: Sistema de escore baseado em alterações nas TCAR de lactentes prematuros. A área pulmonar alterada foi quantificada conforme o número de lobos alterados, acrescido do comprometimento pulmonar bilateral. Dois radiologistas aplicaram o escore em 86 TCAR. Foram analisadas as contabilidades intraobservador e interobservador e calculadas as propriedades do escore em relação à predição da morbidade respiratória no primeiro ano de vida. Resultados: A maioria (85%) dos pacientes apresentou TCAR anormal, e dentre estes, 56,2% apresentaram morbidade respiratória no primeiro ano de vida. Valores do escore variaram de zero a 12. Houve boa concordância entre os observadores (coeficiente de correlação intraclasse, CCI = 0,86, intervalo de confiança, IC: 0,64-0,83). Os valores preditivos do escore foram: valor preditivo positivo 81,8%, valor preditivo negativo 56,3%, sensibilidade 39,1% e especificidade 90,0%. Conclusão: O sistema de escore é reprodutível, de fácil aplicação e permite a comparação de TCAR de pacientes prematuros, identificando pacientes com maior probabilidade de morbidade respiratória no primeiro de vida. Seu uso permitirá a comparação de TC de lactentes prematuros com diferentes fatores de risco para morbidade respiratória. |
| publishDate |
2010 |
| dc.date.issued.fl_str_mv |
2010 |
| dc.date.accessioned.fl_str_mv |
2011-03-21T17:30:46Z |
| dc.date.available.fl_str_mv |
2011-03-21T17:30:46Z |
| dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
| dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
| format |
article |
| status_str |
publishedVersion |
| dc.identifier.citation.fl_str_mv |
BOECHAT, Márcia Cristina Bastos et al. A computed tomography scoring system to assess pulmonary disease among premature infants. São Paulo, Med. J., São Paulo, v. 128, n. 6, p. 328-335, Dec. 2010. |
| dc.identifier.uri.fl_str_mv |
https://www.arca.fiocruz.br/handle/icict/1702 |
| dc.identifier.issn.none.fl_str_mv |
1806-9460 |
| dc.identifier.doi.none.fl_str_mv |
10.1590/S1516-31802010000600004 |
| identifier_str_mv |
BOECHAT, Márcia Cristina Bastos et al. A computed tomography scoring system to assess pulmonary disease among premature infants. São Paulo, Med. J., São Paulo, v. 128, n. 6, p. 328-335, Dec. 2010. 1806-9460 10.1590/S1516-31802010000600004 |
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eng |
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1. Bancalari E, Claure N, Sosenko IR. Bronchopulmonary dysplasia: changes in pathogenesis, epidemiology and definition. Semin Neonatol. 2003;8(1):63-71. 2. de Mello RR, Dutra MV, Ramos JR, et al. Lung mechanics and high-resolution computed tomography of the chest in very low birth weight premature infants. Sao Paulo Med J. 2003;121(4):167-72. 3. Doyle LW, Faber B, Callanan C, et al. Bronchopulmonary dysplasia in very low birth weight subjects and lung function in late adolescence. Pediatrics. 2006;118(1):108-13. 4. Bhandari A, Panitch HB. Pulmonary outcomes in bronchopulmonary dysplasia. Semin Peri- natol. 2006;30(4):219-26. 5. de Mello RR, Dutra MV, Lopes JM. Morbidade respiratória no primeiro ano de vida de pre- maturos egressos de uma unidade pública de tratamento intensivo neonatal [Respiratory morbidity in the first year of life of preterm infants discharged from a neonatal intensive care unit]. J Pediatr (Rio J). 2004;80(6):503-10. 6. Aquino SL, Schechter MS, Chiles C, et al. High-resolution inspiratory and expiratory CT in older children and adults with bronchopulmonary dysplasia. AJR Am J Roentgenol. 1999;173(4):963-7. 7. Aukland SM, Halvorsen T, Fosse KR, Daltveit AK, Rosendahl K. High-resolution CT of the chest in children and young adults who were born prematurely: findings in a population-based study. AJR Am J Roentgenol. 2006;187(4):1012-8. 8. Mahut B, De Blic J, Emond S, et al. Chest computed tomography findings in bronchopul- monary dysplasia and correlation with lung function. Arch Dis Child Fetal Neonatal Ed. 2007;92(6):F459-64. 9. de Mello RR, Dutra MV, Ramos JR, et al. Neonatal risk factors for respiratory morbidity during the first year of life among premature infants. Sao Paulo Med J. 2006;124(2):77-84. 10. Oppenheim C, Mamou-Mani T, Sayegh N, et al. Bronchopulmonary dysplasia: value of CT in identifying pulmonary sequelae. AJR Am J Roentgenol. 1994;163(1):169-72. 11. Ochiai M, Hikino S, Yabuuchi H, et al. A new scoring system for computed tomography of the chest for assessing the clinical status of bronchopulmonary dysplasia. J Pediatr. 2008;152(1):90-5; 95.e1-3. 12. Edwards DK. Radiographic aspects of bronchopulmonary dysplasia. J Pediatr. 1979;95(5 Pt 2):823-9. 13. Greenough A, Kavvadia V, Johnson AH, et al. A simple chest radiograph score to predict chronic lung disease in prematurely born infants. Br J Radiol. 1999;72(858):530-3. 14. Toce SS, Farrel PM, Leavitt LA, Samuels DP, Edwards DK. Clinical and roentgenogra- phic scoring systems for assessing bronchopulmonary dysplasia. Am J Dis Child. 1984;138(6):581-5. 15. Weinstein MR, Peters ME, Sadek M, Palta M. A new radiographic scoring system for broncho- pulmonary dysplasia. Newborn Lung Project. Pediatr Pulmonol. 1994;18(5):284-9. 16. Yuksel B, Greenough A, Karani J, Page A. Chest radiograph scoring system for use in pre-term infants. Br J Radiol. 1991;64(767):1015-8. 17. Kubota J, Ohki Y, Inoue T, et al. Ultrafast CT scoring system for assessing bronchopulmonary dysplasia: reproducibility and clinical correlation. Radiat Med. 1998;16(3):167-74. 18. Brasfield D, Hicks G, Soong S, Tiller RE. The chest roentgenogram in cystic fibrosis: a new scoring system. Pediatrics. 1979;63(1):24-9. 19. Chrispin AR, Norman AP. The systematic evaluation of the chest radiograph in cystic fibrosis. Pediatr Radiol. 1974;2(2):101-5. 20. Koscik RE, Kosorok MR, Farrell PM, et al. Wisconsin cystic fibrosis chest radiograph scoring system: validation and standardization for application to longitudinal studies. Pediatr Pul- monol. 2000;29(6):457-67. 21. Weatherly MR, Palmer CG, Peters ME, et al. Wisconsin cystic fibrosis chest radiograph sco- ring system. Pediatrics. 1993;91(2):488-95. 22. Bhalla M, Turcios N, Aponte V, et al. Cystic fibrosis: scoring system with thin-section CT. Radiology. 1991;179(3):783-8. 23. Brody AS, Kosorok MR, Li Z, et al. Reproducibility of a scoring system for computed tomogra- phy scanning in cystic fibrosis. J Thorac Imaging. 2006;21(1):14-21. 24. Helbich TH, Heinz-Peer G, Eichler I, et al. Cystic fibrosis: CT assessment of lung involvement in children and adults. Radiology. 1999;213(2):537-44. 25. Maffessanti M, Candusso M, Brizzi F, Piovesana F. Cystic fibrosis in children: HRCT findings and distribution of disease. J Thorac Imaging. 1996;11(1):27-38. 26. Shah RM, Sexauer W, Ostrum BJ, Fiel SB, Friedman AC. High-resolution CT in the acute exa- cerbation of cystic fibrosis: evaluation of acute findings, reversibility of those findings, and clinical correlation. AJR Am J Roentgenol. 1997;169(2):375-80. 27. Webb WR, Muller NL, Naidich DP. High-resolution CT of the lung. 3rd ed. Philadelphia: Lippin- cott-Williams & Wilkins; 2001. 28. Lucaya J, Le Pointe. High-resolution CT of the lung in children - technique, indications, ana- tomy, features of lung disease, and clinical application. In: Lucaya J, Strife JL, editors. Pedia- tric chest imaging: chest imaging in infants and children. Berlin: Springer Verlag; 2002. p. 55-92. 29. Hansell DM, Bankier AA, MacMahon H, et al. Fleischner Society: glossary of terms for thora- cic imaging. Radiology. 2008;246(3):697-722. 30. Streiner DL. Learning how to differ: agreement and reliability statistics in psychiatry. Can J Psychiatry. 1995;40(2):60-6. 31. Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;1(8476):307-10. 32. Jobe AH, Bancalari E. Bronchopulmonary dysplasia. Am J Respir Crit Care Med. 2001;163(7):1723-9. 33. Lucaya J, Piqueras J, García-Peña P, et al. Low-dose high-resolution CT of the chest in chil- dren and young adults: dose, cooperation, artifact incidence, and image quality. AJR Am J Roentgenol. 2000;175(4):985-92. |
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