COMPUTED TOMOGRAPHY SEMIOTICS OF NEUROENDOCRINE CELLULAR HYPERPLASIA IN INFANTS: CLINICAL AND RADIOLOGICAL COMPARISONS

The neuroendocrine cell hyperplasia of infancy (NEHI) is an interstitial lung disease (ILD) of an unknown etiology that manifests itself in children of the first year of life and is characterized by the presence of persistent tachypnea of infancy (PTI) syndrome and nonspecific changes in lung biopsy in the form of hyperplasia of bombesin-positive neuroendocrine cells of the peripheral respiratory tract diagnosed in typical cases based on computed tomography (CT) of the lungs. The purpose of the study was to characterize the CT picture of NEHI in comparison with the severity of the disease. Materials and methods of the study: a multicenter observational cross-sectional study that was maintained January, 2012 – March, 2022 portraying 83 patients with NEHI using the NEHI clinical diagnostic scale, ILD severity scale, pulse oximetry, chest CT and echocardiography. Results: CT-semiotics of NEHI is characterized by ground-glass opacification in 97% of cases with predominant localization in the middle lobe of the right lung (89%), upper lobe of the right lung (74%), in the upper lobe of the left lung (72%) and lingual segments (68%) with a prevalence in most cases not exceeding 25% of the total area of the lung fields on sections in the axial projection; parenchymal changes in the form of linear and reticular shading (4%), consolidation (15%), a symptom of «mosaic pneumatization» (35%); and thickening of the walls of the bronchi (28%). Based on the sum of scores on the clinical scale for diagnosing of NEHI, it is impossible to predict the prevalence of CT changes (Rs=0.12, p=0.5), whilst the severity of NEHI does not statistically significantly depend on the ground glass opacification area (Rs=0.27, p=0.13). Conclusion: The most common CT-identified symptoms of NEHI are the symptoms of ground glass and «mosaic pneumatization» as well as the thickening of the bronchial walls. © 2022, Pediatria n.a. G.N. Speransky. All rights reserved.