Application of chest high-resolution computer tomography in young childrenwith cystic fibrosis

High-resolution computed tomography (HRCT) of the chest permits early detec tion of lung disease; two relevant scoring systems (Bhaila and Nathanson) h ave been developed to describe CF lung disease. Comparisons between the two scoring systems have not been made, and it is not known which system is mo re appropriate for young children, i.e., the age group where other objectiv e markers are scarce. We reviewed the clinical findings, pulmonary function data. and HRCT of 16 children aged less than 12 years. The Bhalla scoring system had a better correlation with FEV1 (r = 0.65, P= 0.012) than the Nathanson score (r = 0.53, P = 0.05). All children had bron chiectasis, including 5 with normal pulmonary function tests. The lower lob es were universally involved, and 5 children did not have any upper lobe di sease. Four of these 5 children were aged less than 7 years. We conclude that the Bhalla scoring system is more applicable to young chil dren than is the Nathanson system. Also, in this group of young children wi th CF, lower lobes are more commonly involved than upper lobes, which is in contrast to the classical teaching that CF lung disease begins in the uppe r robes. (C) 2001 Wiley-Liss. Inc.