Relationship between bronchopulmonary dysplasia phenotypes and clinical
outcomes with HRCT score in preterm infants
Abstract
Background: To assess the relationship between high-resolution computed
tomography (HRCT) abnormalities with the clinical phenotypes and
outcomes in preterm bronchopulmonary dysplasia (BPD) infants. Methods:
Totally, 81 preterm infants were enrolled between 2013 and 2020.
Clinical phenotypes of BPD mainly include BPD severity, pulmonary
hypertension (PH), and large airway lesion (LAL). The outcomes included
death before hospital discharge, home oxygen treatment, or home
pulmonary vasodilator therapy, were assessed. Total scores (TS) of
high-resolution CT (HRCT) were summed in every lobe in 7 aspects:
hyperaeration score (HS), composing decreased attenuation, mosaic
attenuation, and bulla/bleb; parenchyma score (PS), composing linear
lesions, consolidation, bronchial wall thickening, and bronchiectasis.
Results: TS (r=0.49), HS (r=0.31), PS (r=0.30), decreased attenuation
(r=0.21), mosaic attenuation (r=0.31), bulla/Bleb (r=0.27) and linear
densities (r=0.55) displayed a correlation with BPD severity. TS
(r=0.28), PS (r=0.35), linear densities (r=0.34) and consolidation
(r=0.24) displayed a correlation with PH. TS (OR 1.11, 95% CI
1.01-1.21), PS (OR 1.17, 95% CI 1.01-1.36) and linear densities (OR
2.23, 95% CI 1.34-3.71) was related to the composite outcomes. Linear
densities (OR 2.30, 95% CI 0.96-5.49), TS (OR 1.16, 95% CI 1.01-1.33)
and HS (OR 1.17, 95% CI 1.01-1.35) was associated with pulmonary
vasodilator. Consolidation (OR 2.09, 95% CI 1.07-4.08) and PS (OR 1.27,
95% CI 1.00-1.60) was closely related to the death. Linear densities
(OR 2.36, 95% CI 1.22-4.57, p=0.01) were risk factors of home oxygen
therapy. Conclusions: HRCT scores were correlated with the BPD severity,
PH and poor clinical outcome.