American Journal of Roentgenology, Vol 163, 557-562, Copyright © 1994 by American Roentgen Ray Society

ARTICLES

Radiographic changes in acute exacerbations of cystic fibrosis in adults: a pilot study

KE Greene, JE Takasugi, JD Godwin, ML Richardson, W Burke and ML Aitken
Department of Medicine, University of Washington Medical Center, Seattle 98195.

OBJECTIVE. We set out to determine whether specific findings can be seen on chest radiographs of adult patients with cystic fibrosis who are having acute exacerbation of respiratory disease. MATERIALS AND METHODS. Over a 2-year period, 22 adults with cystic fibrosis had both a baseline chest radiograph and a radiograph obtained either because of acute exacerbation or for some other reason (nonexacerbation). Fourteen radiographic features, including mucous plugs, air-space disease, peribronchial thickening, bronchiectasis, fluid levels, and lymphadenopathy, were scored retrospectively by two radiologists, who did not have knowledge of the patient's clinical condition, as being present, absent, increased, decreased, or unchanged. An overall assessment (better, worse, or no change) was also given for each radiograph. Data were analyzed in two ways (per individual episode and per individual patient) by using contingency tables, with statistical significance determined by exact permutation testing. RESULTS. Of the 22 patients, 13 had 29 exacerbations and eight had 11 nonexacerbations. The remaining patient had radiographs showing both an exacerbation and a nonexacerbation. With the exception of overall change (p = .06), none of the radiographic variables showed a statistically significant association with exacerbation (mean p value, .66; range, .19-.90). CONCLUSION. The 14 specific radiographic findings studied, including peribronchial thickening, mucous plugs, air-space disease, and fluid levels, were not useful in determining whether an adult patient with cystic fibrosis was having acute exacerbation of the disease. With regard to these individual variables, chest radiographs are not helpful in the management of acute exacerbation of cystic fibrosis in adults. However, overall change approached statistical significance (p = .06). The value of chest radiography lies more in excluding the rare major complication, such as pneumothorax, than in diagnosing the usual exacerbation.
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				S. D. Davis, L. A. Fordham, A. S. Brody, T. L. Noah, G. Z. Retsch-Bogart, B. F. Qaqish, B. C. Yankaskas, R. C. Johnson, and M. W. Leigh Computed Tomography Reflects Lower Airway Inflammation and Tracks Changes in Early Cystic Fibrosis Am. J. Respir. Crit. Care Med., May 1, 2007; 175(9): 943 - 950. [Abstract] [Full Text] [PDF]

				A. S. Brody, H. A. W. M. Tiddens, R. G. Castile, H. O. Coxson, P. A. de Jong, J. Goldin, W. Huda, F. R. Long, M. McNitt-Gray, M. Rock, et al. Computed Tomography in the Evaluation of Cystic Fibrosis Lung Disease Am. J. Respir. Crit. Care Med., November 15, 2005; 172(10): 1246 - 1252. [Abstract] [Full Text] [PDF]

				N R Henig, M R Tonelli, M V Pier, J L Burns, and M L Aitken Sputum induction as a research tool for sampling the airways of subjects with cystic fibrosis Thorax, April 1, 2001; 56(4): 306 - 311. [Abstract] [Full Text]