Etiologic Profile of Older Children With Diffuse Radiological Changes in Eastern China

Xuefeng Xu; Lingke Liu; Xuchen Xu; Qian Ma; Liping Teng; Haichun Zhou; Li Yang; Meiping Lu

doi:10.3389/fped.2022.823350

Etiologic Profile of Older Children With Diffuse Radiological Changes in Eastern China

Front Pediatr. 2022 May 2:10:823350. doi: 10.3389/fped.2022.823350. eCollection 2022.

Authors

Xuefeng Xu¹, Lingke Liu¹, Xuchen Xu¹, Qian Ma¹, Liping Teng¹, Haichun Zhou², Li Yang², Meiping Lu¹

Affiliations

¹ Department of Rheumatology Immunology and Allergy, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China.
² Department of Radiology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China.

Abstract

Objective: To analyze the etiology of chest diffuse radiological changes (DRC) in children older than 2 years.

Methods: A retrospective study was conducted on a primary cohort of children with DRC underwent high resolution computed tomography (HRCT).

Results: DRC mainly included bronchial wall thickening, interlobular septal thickening, pleural thickening, ground glass opacity, mosaic perfusion, reticular & linear opacities, nodular opacity, and tree-in-bud. Of the identified 457 children with DRC, 83 of children older than 2 years with DRC were included in the present study. Ground glass opacity (53, 63.9%) and reticular & linear opacities (44, 53.0%) were frequently identified findings of HRCT, and no tree-in-bud pattern was observed. By contrast, among children with DRC by M. pneumoniae (n = 64), bronchial wall thickening (33, 51.6%), and mosaic perfusion (17, 26.6%) were common patterns of HRCT in addition to ground glass opacity (36, 56.3%). Most of etiologies were connective tissue disease (24, 28.9%), followed by diffuse alveolar hemorrhage syndrome (9, 10.8%), Langerhans cell histiocytosis (7, 8.4%), and recurrent aspiration (6, 7.2%).

Conclusions: This study adds further insights into the role of HRCT in diagnosing childhood interstitial lung diseases, indirectly reflecting disease compositions.

Keywords: children; diffuse radiological changes; etiology; high resolution computed tomography; interstitial lung disease.