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Relationships between lung ultrasound, chest CT, and echocardiographic findings in children with bronchopulmonary dysplasia: A multimodal imaging study
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DOI：10.1016/j.rmed.2026.108775.png)
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Abstract
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This study investigates the use of integrated imaging and functional assessments to detect cardiopulmonary complications in children with bronchopulmonary dysplasia (BPD). Fifteen children with BPD (gestational age 23-30 weeks; assessed at age 7 months to 10 years; 11 severe and 4 moderate) underwent lung ultrasound (LUS), chest computed tomography (CT; available in 12), electrocardiography (ECG), and echocardiography. No healthy control group was included. LUS and CT scores were strongly correlated (r = 0.70, 95% CI 0.20-0.91, p = 0.012). LUS scores correlated with right ventricular (RV) fractional area change (FAC; r = -0.59, 95% CI -0.85 to -0.11, p = 0.022), indicating that worsening lung findings are associated with declining RV performance. TAPSE showed a non-significant trend. An age-dependent relationship between lung ultrasound findings and left ventricular mass index (LVMI) was observed, with younger children showing inverse relationships suggestive of septal displacement due to right-sided overload, while older children exhibited hypertrophic remodeling. ROC analysis identified s' RV velocity as a marker with good discriminatory ability (AUC = 0.828, 95% CI 0.536-1.071, p = 0.007) for distinguishing moderate-to-severe structural changes on CT. Eight of 15 children (53%) had elevated LVMI above the 95th percentile, with a clear age-related trajectory identified through regression analysis. These findings suggest that tissue Doppler s ' RV velocity may serve as a non-invasive marker of CT-defined disease severity, and that LVMI monitoring may help identify cardiac remodeling in children with BPD. Larger prospective studies are needed to validate these findings.
Keywords:
Bronchopulmonary dysplasia
Lung ultrasound
Computed tomography
Echocardiography
Pediatric cardiology
Pulmonary hypertension
Neonatal intensive care
Cardiac remodeling
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