Drs. Gloria Soto
G, Marcela Linares P, Juan C. Díaz P, Juan A. Escaffi J, Fernando
Pedersen M, Noldy Mardones C, D. Busel M, Samuel Gasc H, T.M. Pablo Arancibia
N.
Hospital Padre Hurtado, Santiago, Chile
*Trabajo premiado por el comité de selección en el Congreso
de Radiología 2002.
Abstract
introduction:
Respiratory tract infections caused by Adenovirus (ADV) can lead to long
term lung sequelae. In our media it is the most frequent cause of chronic
lung disease in children. High resolution computed tomography (HRCT) can
characterize the anatomic alterations of this disease. Functional impairment
is evaluated with spirometry, which only can be performed in collaborating
patients. Purpose: Characterize the appearances of chronic lung disease
secondary to ADV infection on HRCT, relate the extent of HRCT abnormalities
to pulmonary function impairment, and determine if HRCT can be used to
assess pulmonary function when functional tests cannot be performed. Material
and methods: HRCT findings in 17 pediatric patients with post adenoviral
chronic lung disease were analyzed. HRCT findings were correlated with
spirometry in 11 of these children using the modified Bhalla score for
bronchial dilatation and the modified Siegel score for mosaic lung attenuation.
Results: HRCT findings were mosaic perfusion and bronchial wall thickening
in 17/17, bronchial dilatation and centrilobular nodules in 16/17, atelectasis
in 11/17, and tree in bud in 8/17. Very good correlation was found between
the scores of mosaic lung attenuation and bronchial dilatation with the
forced expiratory volume in one second. Conclusion: A characteristic pattern
of findings on HRCT is present in children with post adenovirus chronic
lung disease. There is good correlation between the severity of mosaic
lung attenuation and bronchial dilatation with pulmonary functional impairment.
These results suggest that HRCT findings can be used to assess pulmonary
function in those children in which pulmonary function tests cannot be
performed.
Key words:
Adenovirus, Bronchiolitis obliterans, Pulmonary function.
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| Figura a. | Figura b. |
|
Cortes
de alta resolución al mismo nivel en inspiración (a)
y espiración (b). En espiración el patrón en
mosaico se hace más evidente por atrapamiento de aire en
las zonas comprometidas. Este es un recurso que ayuda en la diferenciación
entre patología vascular y de la vía aérea.
|
Soto G. y cols.Tomografía computada de alta resolución en niños con daño pulmonar por adenovirus: Caracterización y correlación con función pulmonar. Rev Chil Radiol 2002; 8: 149-153.
| Volver al sumario volumen 8, número 4 |