Interstitial Lung Disease in Children

Targeted CE per ARRT’s Discipline, Category, and Subcategory classification:
[Note: Discipline-specific Targeted CE credits may be less than the total Category A credits approved for this course.]

Computed Tomography: 1.00
Procedures: 1.00
Neck and Chest: 1.00

Radiography: 0.50
Procedures: 0.50
Thorax and Abdomen Procedures: 0.50

Registered Radiologist Assistant: 2.00
Procedures: 2.00
Thoracic Section: 2.00

Sonography: 0.50
Procedures: 0.50
Superficial Structures and Other Sonographic Procedures: 0.50

Outline

1. Introduction
2. Review of Pulmonary Embryology
   1. Embryonic Stage (Weeks 4-7
   2. Pseudoglandular Stage (Weeks 5-17
   3. Canalicular Stage (Weeks 16-26
   4. Saccular Stage (Weeks 24 to Term
   5. Alveolarization Stage (Week 36 to 21 Years
3. Imaging Modalities
   1. Chest Radiography
   2. Ultrasonography
   3. Computed Tomography
4. chILD Entities More Prevalent in Infancy
   1. Diffuse Developmental Disorders
   2. Lung Growth Abnormalities
      1. Pulmonary Hypoplasia
      2. Chronic Nenotal Lung Disease
      3. Structural Pulmonary Changes with Chromosomal Abnormalities
   3. Specific Conditions of Undefined Origin
      1. Pulmonary Interstitial Glycogenosis
      2. Neuroendocrine Hyperplasia of Infancy
5. chILD Entities Not Specific to Infancy
   1. Disorders of the Normal Host
      1. Infectious and Postinfectious Processes
      2. Disorders Related to Environmental Agents
      3. Aspiration Syndromes
      4. Eosinophilic Pneumonias
   2. Disorders Related to Systemic Disease Processes
      1. Immune-related Disorders
      2. Storage Diseases
      3. Sarcoidosis
      4. Langerhans Cell Histiocytosis
   3. Disorders of the Immunocompromised Host
      1. Disorders Related to Transplantation and Rejection Syndromes
      2. Idiopathic Pleuroparenchymal Fibroelastosis
   4. Disorders Masquerading as Interstitial Disease
      1. Arterial Hypertensive Vasculopathy: Congestive Vasculopathy, Including Veno-occlusive Disease
      2. Lymphatic Disorders
6. Unclassified Disease
7. Conclusion

Objectives

Upon completion of this course, students will:

1. state the reported prevalence of chILD in children under 15 years of age
2. recall the respiratory failure rate in neonates with surfactant protein B mutations
3. list factors associated with standardized classification that aid in understanding chILD
4. list the societies currently classifying interstitial lung disease in the adult population
5. explain how the lungs begin development in the embryonic stage
6. list the stages of development associated with pulmonary embryology
7. state when the first alveolar ducts form
8. recall how the alveolar ducts grow in the canalicular stage
9. express how many phases there are in alveolarization
10. state the imaging modality that is fast, easily reproducible, and inexpensive in the diagnosis of pulmonary disease
11. state the imaging modality that is the reference standard for radiologic investigation of interstitial lung disease
12. explain how CT for interstitial lung disease diagnosis is performed in patients over 5 years of age
13. state what type of CT images are not usually indicated in the assessment of interstitial lung disease and are reserved for difficult cases
14. describe how the interlobular septum may appear on CT
15. list the phases where developmental arrest can result in acinar dysplasia
16. describe pulmonary hypoplasia
17. list contributing factors for classic bronchopulmonary dysplasia
18. describe how bronchopulmonary dysplasia presents on chest radiography in extremely premature infants
19. express pulmonary factors associated with trisomy 21
20. list the CT findings for pulmonary interstitial gylcogenosis
21. list findings associated with neuroendocrine hyperplasia of infancy
22. relate specific gene mutations to related lung disorders
23. list the symptoms of postinfectious constrictive obliterative bronchiolitis
24. state the percentage of children with chILD that experience chronic aspiration
25. recall the approximate percentage of children with systemic sclerosis that have pulmonary disease
26. describe Gaucher disease
27. describe Niemann-Pick disease
28. associate LIP and follicular bronchitis with specific immune diseases
29. state the most common disease site form transplant-associated thrombotic microangiopathy to occur
30. recall when diffuse pulmonary lymphatic disorders manifest