DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20185096

Decoding neonatal chest radiographic patterns of disease: retrospective analysis from a tertiary care hospital

Rohini Gupta Ghasi

Abstract


Background: To evaluate chest radiographic patterns in neonatal respiratory distress using a predesigned performa and algorithm and to correlate results with the clinical diagnosis.

Methods: A retrospective review was done of bedside chest radiographs acquired over a month for respiratory distress from the neonatal intensive care unit. The radiographs were systematically evaluated according to a predesigned performa and algorithm. A presumptive radiographic diagnosis was assigned to each patient based on the combination of radiographic features. Radiographic diagnosis was compared with the clinical diagnosis. The most important diagnostic features were outlined.

Results: The radiographic diagnosis correlated with clinical diagnosis in 93.3% of cases. Most common radiographic feature was pulmonary air space opacity (n=21). Air space opacity without any mediastinal shift in absence of any compensatory factors was a reliable diagnostic feature for pneumonic consolidation, which was the most common diagnosis (n=10). Bilateral granular lung fields were a specific indicator of respiratory distress syndrome. Flattening of domes of diaphragm was the most frequent feature for hyperinflation. Bilateral hyperinflation could be accurately used to diagnose bronchiolitis in all but one case (n=4/5). Pleural complications were accurately diagnosed.

Conclusions: Systematic evaluation of neonatal chest radiographic patterns of disease has a high diagnostic accuracy.


Keywords


Bronchiolitis, Chest radiograph, Neonatal respiratory distress, Respiratory distress syndrome

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References


Reuter S, Moser C, Baack M. Respiratory distress in the newborn. Pediatrics in review. 2014;35:417-29.

Pramanik AK, Rangaswamy N, Gates T. Neonatal respiratory distress: A practical approach to its diagnosis and management. Pediatr Clin north Am. 2015;62:453-69.

Liszewski MC, Stanescu AL, Phillips GS, Lee EY. Respiratory Distress in Neonates. Radiol Clin North Am. 2017;55:629-44.

Lobo L. The neonatal chest. Eur J Radiol. 2006;60:152-8.

Alford BA, McIlhenny J. An approach to asymmetric neonatal chest radiograph. Radiol Clin North Am. 1999;37:1079-92.

Pederson CCE, Hardy M, Blankholm AD. An Evaluation of Image Acquisition Techniques, Radiographic Practice, and Technical Quality in Neonatal Chest Radiography. J Med Imaging Radiat Sci. 2018;49:257-64.

Menashe SL, Iyer RL, Parisi MT, Otto RK, Stanescu AL. Pediatric chest radiographs: common and less common errors. AJR. 2016;207:903-11.

Fink AZ, Levin TL, Blumfield E, Nemerofsky SL, Liszweski MC, George K, et al. Discrepancies in radiographic interpretation between pediatric radiologists and pediatric intensivists in the pediatric or neonatal intensive care unit. J Am Coll Radiol. 2018;15:1580-6.

Edwards MO, Kotecha SJ, Kotecha S. Respiratory distress of the term newborn infant. Pediatr Resp Rev. 2013;14:29-37.

Suprenant S, Coghlan MA. Respiratory distress in the newborn: an approach for the emergency care provider. Clin Pedia Emerg Med. 2016;17:113-21.

Haney PJ, Bohlman M, Sun CCJ. Radiographic findings in neonatal pneumonia. AJR. 1984;143:23-6.

Schweigmann G, Gassner L, Maurer K. Imaging the neonatal heart-Essentials for the radiologist. Eur J Radiol. 2006;60:159-70.