Radiology Imaging of Bronchiectasis in Children and Adolescents (Literature Review with Own Observations)

Abstract

Timely detection of bronchiectasis in children is of great prognostic value. The importance of modern bronchiectasis in children is due to their possible reversibility over time with effective treatment, as well as a number of significant differences between bronchiectasis in childhood and onset in children, which may reflect different phenotypes of bronchiectasis. In adult patients with bronchiectasis that began in childhood, the pathological process has a more severe and worse prognosis compared to bronchiectasis that began in adulthood. In 2020, the European Respiratory Society proposed a new formulation of the terminal «bronchiectasis» for children and adolescents, now this term refers to an abnormal expansion of the bronchi by computed tomography (CT) of the chest, which, if detected early, can be reversible. CT is the true «gold standard» for confirming bronchiectasis in children and adolescents. This method is included in the minimum set of tests for children and adolescents with suspected bronchiectasis according to the recommendations of the European Respiratory Society. When conducting CT, it is recommended to perform a continuous spiral scan with a collimation of 1 mm, the study is carried out without intravenous use using low-dose protocols. To assess the state of the bronchi in children and adolescents, it is necessary to use the pediatric norms of the broncho-arterial ratio (> 0.8). At the same time, radiation methods are not decisive in establishing the causes of bronchiectasis and only in rare cases can help in establishing bronchiectasis. Dynamic observation of bronchiectasis for children and adolescents is determined individually. Consideration should be given to repeat chest computed tomography scans to answer the question that will change treatment.