Interstitial Lung Disease in Children: High-Resolution CT Findings in 14 Patients

Purpose: To assess the high-resolution computed tomography (HRCT) features of childhood interstitial lung disease (ChILD) and the differences from adult interstitial lung disease. Methods and Materials: 14 patients with ChILD proven histopathologically were enrolled in the current study. Among them, there were 10 boys and 4 girls, aged from 1y3m to 13y1m (the median age was 6y). The final diagnoses of this series included nonspecific interstitial pneumonia, NSIP (NSIP) (n=6), lymphocytic interstitial pneumonia (LIP) (n=3), pulmonary alveolar proteinosis (PAP) (n=2), respiratory bronchiolitis interstitial lung disease (RB-ILD) (n=1), acute interstitial pneumonia (AIP, histopathologic pattern as known as diffuse alveolar damage) (n=1), and Eosinophilic Pneumonia (EP) (n=1). Results: The most common HRCT patterns of NSIP included reticulation, ground-glass opacity (GGO) and peribronchiolar thickness (6/6, 100%). Nodules were always present on the HRCT of children with LIP (3/3, 100%). In the two PAP patients, there was the specific sign, named ”crazy-paving sign”, (2/2, 100%) could be found. The nodules with hazy margin in EP were different from that in LIP. Nodule, reticulation and GGO were present in the boy with AIP. The reticulation, GGO, consolidation and peribronchiolar thickening were present in RB-ILD patient. By the analysis with logistic regression, the nodule was regarded as the specific negativepattern for NSIP (P=0.047＜0.05, OR=-2.71) in our study. There was no other elementary lesion was considered as specific pattern of any subset of ChILD. Conclusions: HRCT scanning is the primary imaging modality for ChILD. HRCT findings contribute to detection, evaluation of pulmonary damage prognosis and screening for complications. So far, however, there is no sign would be identified as the specific pattern for any subsets of childhood interstitial lung disease.