Structural changes on high resolution computed tomography (HRCT) in adult individuals with a history of bronchopulmonary dysplasia (BPD)

Bronchopulmonary dysplasia (BPD) in infancy is a risk factor for lung disease later in life. We aimed to characterize structural abnormalities by high resolution computed tomography (HRCT) in adult individuals born preterm. We included individuals born preterm (<32 gestational weeks) with (n=24) or without (n=23) a previous diagnosis of BPD, and compared them to patients with mild allergic asthma (>37 weeks, n=22) and healthy controls (>37 weeks, n=24) from the LUNAPRE cohort (clinicaltrials.gov/ct2/show/NCT02923648). Their median (range) age was 19.8 (18.3-24.0) years. All participants underwent inspiratory and expiratory HRCT scans which blindly were interpreted by two experienced reviewers using a scoring system. Linear/triangular subpleural lung opacities (p<0.05 for both), and local hypoattenuation (p<0.01) were more common in individuals with BPD compared to the other groups. Architectural distortion was more common in the BPD group compared to healthy controls and asthmatic individuals (p<0.01, p<0.05). Bronchial wall thickening was more frequent in the BPD group compared to healthy and premature individuals (p<0.05 for both). In individuals with BPD, air trapping was predominant compared to healthy controls (p<0.05). At least one HRCT abnormality was found in most (92%) premature with BPD compared to premature without BPD (74%), asthmatics (73%) and healthy controls (62%). We conclude that most young adults with a history of BPD have structural lung abnormalities on HRCT, which is likely a consequence of lung insults in the neonatal period. These findings may be linked to functional impairment and lung disease later in adulthood.