A Computed tomography scoring system to assess pulmonary disease among premature infants

Um sistema de escore por tomogra a computadorizada para avaliação da doença pulmonar em lactentes prematuros

dc.creatorBoechat, Márcia Cristina Bastos
dc.creatorMello, Rosane Reis de
dc.creatorSilva, Kátia Silveira da
dc.creatorDaltro, Pedro
dc.creatorMarchiori, Edson
dc.creatorRamos, Eloane Guimarães
dc.creatorDutra, Maria Virgínia Peixoto
dc.date2011-03-21T17:30:46Z
dc.date2011-03-21T17:30:46Z
dc.date2010
dc.date.accessioned2023-09-26T20:20:02Z
dc.date.available2023-09-26T20:20:02Z
dc.identifierBOECHAT, Márcia Cristina Bastos et al. A computed tomography scoring system to assess pulmonary disease among premature infants. São Paulo, Med. J., São Paulo, v. 128, n. 6, p. 328-335, Dec. 2010.
dc.identifier1806-9460
dc.identifierhttps://www.arca.fiocruz.br/handle/icict/1702
dc.identifier10.1590/S1516-31802010000600004
dc.identifier.urihttps://repositorioslatinoamericanos.uchile.cl/handle/2250/8854477
dc.descriptionCONTEXTO E Objetivo: Tomografia computadorizada de alta resolução (TCAR) é considerada o melhor método para avaliação pulmonar detalhada. O objetivo foi descrever um sistema de escore baseado em alterações identificadas nas TCAR de lactentes prematuros e medir a validade preditiva do escore em relação à morbidade respiratória no primeiro ano de vida. TIPO DE ESTUDO E LOCAL: Estudo de coorte prospectiva no Instituto Fernandes Figueira, Fundação Oswaldo Cruz. Métodos: Sistema de escore baseado em alterações nas TCAR de lactentes prematuros. A área pulmonar alterada foi quantificada conforme o número de lobos alterados, acrescido do comprometimento pulmonar bilateral. Dois radiologistas aplicaram o escore em 86 TCAR. Foram analisadas as contabilidades intraobservador e interobservador e calculadas as propriedades do escore em relação à predição da morbidade respiratória no primeiro ano de vida. Resultados: A maioria (85%) dos pacientes apresentou TCAR anormal, e dentre estes, 56,2% apresentaram morbidade respiratória no primeiro ano de vida. Valores do escore variaram de zero a 12. Houve boa concordância entre os observadores (coeficiente de correlação intraclasse, CCI = 0,86, intervalo de confiança, IC: 0,64-0,83). Os valores preditivos do escore foram: valor preditivo positivo 81,8%, valor preditivo negativo 56,3%, sensibilidade 39,1% e especificidade 90,0%. Conclusão: O sistema de escore é reprodutível, de fácil aplicação e permite a comparação de TCAR de pacientes prematuros, identificando pacientes com maior probabilidade de morbidade respiratória no primeiro de vida. Seu uso permitirá a comparação de TC de lactentes prematuros com diferentes fatores de risco para morbidade respiratória.
dc.descriptionCONTEXT AND Objective: High-resolution computed tomography (HRCT) is considered to be the best method for detailed pulmonary evaluation. The aim here was to describe a scoring system based on abnormalities identified on HRCT among premature infants, and measure the predictive validity of the score in relation to respiratory morbidity during the first year of life. DESIGN AND SETTING: Prospective cohort study in Instituto Fernandes Figueira, Fundação Oswaldo Cruz. Methods: Scoring system based on HRCT abnormalities among premature newborns. The affected lung area was quantified according to the number of compromised lobes, in addition to bilateral pulmonary involvement. Two radiologists applied the score to 86 HRCT scans. Intraobserver and interobserver agreement were analyzed. The score properties were calculated in relation to predictions of respiratory morbidity during the first year of life. Results: Most of the patients (85%) presented abnormalities on HRCT, and among these, 56.2% presented respiratory morbidity during the first year of life. Scores ranged from zero to 12. There was good agreement between observers (intraclass correlation coefficient, ICC = 0.86, confidence interval, CI: 0.64-0.83). The predictive scores were as follows: positive predictive value 81.8%, negative predictive value 56.3%, sensitivity 39.1%, and specificity 90.0%. Conclusion: The scoring system is reproducible, easy to apply and allows HRCT comparisons among premature infants, by identifying patients with greater likelihood of respiratory morbidity during the first year of life. Its use will enable HRCT comparisons among premature infants with different risk factors for respiratory morbidity.
dc.formatapplication/pdf
dc.languageeng
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dc.rightsopen access
dc.subjectTomografia
dc.subjectTomografia Computadorizada por Raios X
dc.subjectPrematuro
dc.subjectPulmão
dc.subjectDisplasia Broncopulmonar
dc.subjectTomography
dc.subjectTomography, X-ray Computed
dc.subjectInfant, Premature
dc.subjectLung
dc.subjectBronchopulmonary Dysplasia
dc.subjectDoenças do Prematuro - radiografia
dc.subjectPneumopatias - radiografia
dc.subjectTomografia Computadorizada por Raios X - métodos
dc.subjectMétodos Epidemiológicos
dc.subjectPrematuro
dc.subjectDoenças do Prematuro - mortalidade
dc.subjectDoenças do Prematuro - patologia
dc.subjectPneumopatias - mortalidade
dc.subjectPneumopatias - patologia
dc.subjectTomografia Computadorizada por Raios X - normas
dc.titleA Computed tomography scoring system to assess pulmonary disease among premature infants
dc.titleUm sistema de escore por tomogra a computadorizada para avaliação da doença pulmonar em lactentes prematuros
dc.typeArticle


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