The Diagnostic Value Of Chest HRCT Follow-up In Children With Post-infectious Bronchiolitis Obliterans

Objective: To evaluate the diagnostic and differential value of chest HRCT in children with post-infectious bronchiolitis obliterans.Methods: According to the final follow-up results,133 hospitalized children with suspected PIBO were divided into three groups :group PIBO,group asthma and group simple infectious,who were in our hospital from March 2014 to March 2020.The chest HRCT findings and differences between the three groups during hospitalization and outpatient follow-up were compared.Results: There are 77 children in group PIBO,34 children in group asthma,22 children in group simple infection.During the chest HRCT follow-up period,33 cases of atelectasis,41 cases of ground glass opacity,57 cases of mosaic pattern,41 cases of bronchial wall thickening and 48 cases of bronchiectasis were found in group PIBO;6 cases of atelectasis,16 cases of ground glass opacity,23 cases of mosaic pattern,5 cases of bronchial wall thickening and 1 case of bronchiectasis were found in group asthma;1 case of atelectasis,9 cases of ground glass opacity,19 cases of mosaic pattern,2 cases of bronchial wall thickening and 1 case of bronchiectasis were found in group simple infection.The proportion of ground glass opacity and mosaic pattern among the three groups were no significant difference(P>0.05),but the proportion of atelectasis,bronchial wall thickening and bronchiectasis in group PIBO was higher than the other two groups(Bonferroni correction,P<0.0167).The follow-up time of chest HRCT in group PIBO with 77 children was 14.3(8.2,24.0)months,all patients had mosaic pattern,bronchial wall thickening,bronchiectasis or atelectasis sign;The follow-up time of chest HRCT in group asthma with34 children was 8.6(3.6,14.8)months,23 cases of mosaic pattern,5 cases of bronchial wall thickening,1 case of bronchiectasis and 6 cases of atelectasis were disappeared and the disappearance time was 7.5(3.4,12.0)months;The follow-up time of chest HRCT in group simple infection with22 children was 3.2(2.1,4.1)months,19 cases of mosaic pattern,2 cases of bronchial wall thickening,1 case of bronchiectasis and 1 case of atelectasis were disappeared and the disappearance time was 3.2(2.1,4.1)months.Conclusion: The mosaic pattern,atelectasis,bronchiectasis and bronchial wall thickening on chest HRCT persist in the PIBO children,while these signs are reversible in the children with pneumonia or asthma.Re-examination of chest HRCT in 3.2 months and 7.5 months of the course may help to diagnose and differentiate PIBO.