To assess the relationship between high-resolution computed tomography (HRCT) abnormalities and clinical phenotypes of bronchopulmonary dysplasia (BPD).

A retrospective, single-center study was carried out at the Children’s Hospital of Fudan University between 2013 and 2020. Preterm infants born at ≤ 32 weeks’ gestation who were diagnosed with BPD and had HRCT between 40 and 50 weeks postmenstrual age (PMA)were included in the study. HRCT images from six pulmonary lobes were scored based on seven types of pulmonary lesions from two categories: hyperaeration lesions and parenchymal lesions. The hyperaeration score (HS) included scores of decreased attenuation, mosaic attenuation, and bulla/bleb, while the parenchymal score (PS) included those of linear lesion, consolidation, bronchial wall thickening, and bronchiectasis. All seven scores were summed up to create the total score (TS). One-way ANOVA testing or Kruskal-Wallis testing was adopted for the comparison of HRCT scores with BPD severity and clinical phenotypes. The correlation between HRCT scores and clinical phenotypes was evaluated by Spearman’s correlation analysis.

A total of 81 cases were included in the study. Cases with more severe BPD had a higher TS (p = 0.01), HS (p = 0.02), PS (p = 0.02), mosaic attenuation score (p = 0.03), bulla/Bleb score (p = 0.03), and linear density score (p = 0.01). TS (r = 0.28), PS (r = 0.35), linear density (r = 0.34), and consolidation (r = 0.24) were correlated with pulmonary hypertension (PH). However, no HRCT score was significantly different between the patients with or without tracheobronchomalacia (TBM). BPD patients with a combination of lung parenchymal disease, PH, and TBM had the highest TS and HS.

HRCT scores correlated with BPD severity and PH in our study. HS might be a useful tool in the assessment of BPD severity while linear densities and consolidation might be helpful in predicting PH.

评估高分辨率计算机断层扫描 (HRCT) 异常与支气管肺发育不良 (BPD) 临床表型之间的关系。

复旦大学儿童医院于 2013 年至 2020 年开展了一项回顾性、单中心研究。出生于≤32 周孕期的早产儿被诊断为 BPD，并在经后 40 至 50 周龄（PMA）进行 HRCT。纳入研究。来自六个肺叶的 HRCT 图像根据来自两类的七种肺部病变进行评分：过度通气病变和实质病变。通气过度评分（HS）包括衰减降低、马赛克衰减和大疱/大疱评分，而实质评分（PS）包括线性病变、实变、支气管壁增厚和支气管扩张。将所有七个分数相加得出总分 (TS)。采用单因素 ANOVA 测试或 Kruskal-Wallis 测试来比较 HRCT 评分与 BPD 严重程度和临床表型。通过Spearman相关分析评估HRCT评分与临床表型之间的相关性。

共有 81 例病例被纳入研究。BPD 更严重的病例具有更高的 TS（p= 0.01），HS（p= 0.02), PS (p= 0.02), 马赛克衰减分数 (p= 0.03)，bulla/Bleb 评分 (p= 0.03）和线密度得分（p= 0.01)。TS（r= 0.28), PS (r= 0.35), 线密度 (r= 0.34）和合并（r= 0.24) 与肺动脉高压 (PH) 相关。然而，有或没有气管支气管软化症（TBM）的患者之间的 HRCT 评分没有显着差异。合并肺实质疾病、PH 和 TBM 的 BPD 患者的 TS 和 HS 最高。

在我们的研究中，HRCT 评分与 BPD 严重程度和 PH 相关。HS 可能是评估 BPD 严重程度的有用工具，而线性密度和巩固可能有助于预测 PH。