Document Type : Original Article

Authors

1 1. Pediatric ward, Child Growth and Development Reaserch Center, Research Institute of Perimordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran

2 -Department of Rdiology, Emam Hossein children's hospital, Isfahan University of Medical Sciences, Isfahan, Iran

3 Pediatrics Department, Emam Hossein children's hospital, Isfahan University of Medical Sciences, Isfahan, Iran. Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease,

4 Department of Pediatric Pulmonology, Pediatrics Department, Emam Hossein children's hospital, Isfahan University of Medical Sciences, Isfahan, Iran. Child Growth and Development Research Center, Research Institute for Primordial

10.22038/ijn.2024.75677.2457

Abstract

Introduction:This study was performed to determine the relationship between chest X-ray findings and the severity of bronchiolitis in terms of the modified Tal score scale(MTS).

Methods:This cross-sectional study was conducted among 999 children aged 1 month to 2 years who were admitted to a referral teaching hospital in Isfahan, Iran .The severity of bronchiolitis was determined by MTS criteria, with scores ranging from 0 to 12. We considered scores 0-5 as mild, 6-9 as moderate, and 10-12 as severe bronchiolitis.The patient's CXRs were also extracted from the picture archiving and communication system (PACS) of the hospital and were reported by an expert Pediatric radiologist. The radiologic findings were compared with the MTS criteria.

Results:The mean(SD) of the MTS score in the patients was 4.58 ± 1.92. The severity of bronchiolitis was mild in 699 (70%), moderate in 291(29.12%), and severe in 9 patients(0.9%).Overall, 757 patients (75.78%) had normal radiographies, and no significant radiological findings were seen in 993 patients (99.3%).The frequency of normal radiography was 75.3% in the group of mild bronchiolitis and 77.3% in the group of moderate bronchiolitis. Reports of 9 patients with the severe disease showed that 6 of them had normal CXRs(66.7%), 2 had hyperinflation, and 1 had atelectasis. There was no statistically significant relationship between radiographic results and severity of bronchiolitis, according to MTS criteria (P = 0.23). The agreement between radiographic results and the severity of bronchiolitis was very weak (0.004) without statistical significance (P = 0.632).

Conclusion: The findings of the present study show that 76.9% of children with bronchiolitis did not have any abnormal findings on CXR, and in 99.3%, no significant radiological findings were seen. Thus, given that a high percentage of children with bronchiolitis have normal radiographic appearance of the lungs, routine chest radiography is not recommended in these patients.

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