Radiographic outcome and impact factors in children with bronchiectasis.

BACKGROUND: This study aims to investigate the radiological outcomes in children with bronchiectasis under current treatment strategies through a real-world prospective observational study, and to conduct a preliminary analysis of potential influencing factors. METHODS: A total of 492 pediatric patients with bronchiectasis who underwent chest HRCT were enrolled from the Children's Hospital of Chongqing Medical University between January 2018 and December 2022, with follow-up extending until June 2024. Reversible imaging changes in bronchiectasis were determined by comparing changes in chest HRCT and modified Reiff scores (MRS). Univariable logistic regression models were used to preliminarily screen for factors related to imaging prognosis; variables with a significance level of P < 0.05 were subsequently included in multivariable logistic regression models for further analysis. RESULTS: Ultimately, 273 eligible pediatric patients were included in the final analysis, after excluding those lost to follow-up, those without follow-up chest HRCT, and those who underwent lobectomy. Reversible imaging changes were observed in 125 patients (45.8%), comprising 72 cases (26.4%) of complete radiological remission and 53 cases (19.4%) of improvement. Conversely, 148 patients (54.2%) exhibited stable or progressive disease. Multivariable logistic regression analysis revealed that localized radiological changes were significantly associated with radiological reversibility (OR=1.82, 95% CI 1.11-3.00; P =0.018). Bronchiectasis associated with a genetic condition and any acute exacerbation of respiratory symptoms during follow-up showed a significant negative association with radiological reversibility (OR=0.48, 95% CI 0.25-0.91; P =0.028 and OR=0.58, 95% CI 0.35-0.97; P =0.038, respectively). CONCLUSION: Pediatric bronchiectasis is partially reversible with appropriate treatment within a reasonable follow-up period. Patients with localized radiological changes are most likely to exhibit reversible imaging changes, whereas those with comorbid genetic diseases and recurrent infections are the least likely to do so.