The British Journal of Radiology, Vol 69, Issue 818 122-125, Copyright © 1996 by British Institute of Radiology

ARTICLES

Early focal abnormalities on chest radiographs and respiratory prognosis in children with cystic fibrosis

S Mukhopadhyay, ML Kirby, AW Duncan and F Carswell
Department of Child Health, University of Dundee, UK.

The variable rate of progression of respiratory disease in cystic fibrosis demands reliable prognostic markers for rational treatment. This study aims to determine whether or not focal abnormalities on chest radiographs during the early clinical course of cystic fibrosis could be used as such a marker. A retrospective review of patient records was carried out. Demographic details, genotype, presentation, and course of respiratory disease over the first 6 years were recorded for all patients, together with spirometry and chest radiograph scores at 7 and 13 years for surviving patients. Comparison was made between those with and those without documented focal opacification on chest radiography during the first 6 years of life. 30 patients satisfied the study entry criteria and had complete records available. Of these, 17 had focal consolidation documented during the first 6 years, and 13 did not. Survival was significantly worse in those with previous consolidation (p < 0.01), as was peak expiratory flow at 7 years (p = 0.02). There were no other statistically significant differences between the groups, although those with previous consolidation apparently had worse lung function and more advanced disease on chest radiography at both 7 and 13 years. This study suggests that early focal chest radiographic abnormalities may predict a poorer outcome in cystic fibrosis.