Application of chest high-resolution computer tomography in young children with cystic fibrosis.

SUMMARY. High-resolution computed tomography (HRCT) of the chest permits early detection of lung disease; two relevant scoring systems (Bhalla and Nathanson) have 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 more appropriate for young children, i.e., the age group where other objective 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 FEV(1) (r = -0.65, P = 0.012) than the Nathanson score (r = 0.53, P = 0.05). All children had bronchiectasis, including 5 with normal pulmonary function tests. The lower lobes were universally involved, and 5 children did not have any upper lobe disease. Four of these 5 children were aged less than 7 years. We conclude that the Bhalla scoring system is more applicable to young children than is the Nathanson system. Also, in this group of young children with 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 upper lobes.