Volume 04 Issue 06-2024
31
American Journal Of Biomedical Science & Pharmaceutical Innovation
(ISSN
–
2771-2753)
VOLUME
04
ISSUE
06
P
AGES
:
31-40
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
ABSTRACT
The choice of this particular topic is due to the need to study morphofunctional studies and compare them with
radiological data. The literature shows that in order to improve and timely diagnosis and prevention of inflammatory
diseases of the bronchopulmonary system, the director carries out radiological diagnostic methods. Morphological
studies of pleural fluid can affect the diagnosis and treatment of children with pneumonia.
KEYWORDS
Morphology, bronchopulmonary system, X-ray examination.
INTRODUCTION
According to recent data, more than 30% of children
are admitted to hospitals due to inflammatory
processes of the bronchopulmonary system in
children. Connections with this, the development of
science, technology, industry, and the urbanization of
today's life have led to the emergence of the problem
of radiodiagnosis of inflammatory processes of the
bronchopulmonary system in children. In addition, the
Research Article
MORPHORANGENOLOGICAL CHARACTERISTICS IN EARLY DIAGNOSIS
OF CHILDREN WITH INFLAMMATORY PULMONARY DISEASES
Submission Date:
June 10, 2024,
Accepted Date:
June 15, 2024,
Published Date:
June 20, 2024
Crossref doi:
https://doi.org/10.37547/ajbspi/Volume04Issue06-06
Akhmedov Y. A.
Samarkand State Medical University, Samarkand, Uzbekistan
Khamidova F. M.
Samarkand State Medical University, Samarkand, Uzbekistan
Narzikulov Sh. F.
Samarkand State Medical University, Samarkand, Uzbekistan
Journal
Website:
https://theusajournals.
com/index.php/ajbspi
Copyright:
Original
content from this work
may be used under the
terms of the creative
commons
attributes
4.0 licence.
Volume 04 Issue 06-2024
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American Journal Of Biomedical Science & Pharmaceutical Innovation
(ISSN
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2771-2753)
VOLUME
04
ISSUE
06
P
AGES
:
31-40
OCLC
–
1121105677
Publisher:
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increase in the frequency of pathology of inflammatory
processes of this system in children has made the
urgent problem of their radiological diagnosis in the
structure of childhood diseases, especially at an early
age (1, 2, 3, 4).
Respiratory diseases occupy a leading position among
all diseases. The same trend was noted in pediatric
practice, where their share is more than 60% (5, 6, 7, 8,
9).
The problem of preventing and treating inflammatory
diseases of the bronchopulmonary system in children
still remains relevant. In the structure of primary
morbidity, this pathology occupies one of the first
places in children of all age groups (10, 11, 12, 13, 14).
Respiratory diseases are the most common pathology
in childhood. Pulmonary diseases account for one in six
deaths worldwide (15, 16, 17, 18, 19). In Russia, the
incidence of acute respiratory tract infections is 672.1
per 1000 children. (3, 14, 15, 20). These diseases are
fraught with various complications. At the same time,
there is an increase in the frequency of severe chronic
forms of lung diseases in children, leading to disability
already in childhood (21, 17, 31, 49, 69, 73, 95).
The morphology of the functional activity of the
structures of the airways and lungs under normal
conditions and in a number of pathological conditions
has been studied in great detail. Assessing the changes
that develop in the bronchopulmonary system during
a particular inflammatory pathological process serves
as the basis for understanding the patterns of
compensatory and adaptive reactions in the
respiratory organs. Respiratory diseases are an urgent
health problem due to their widespread prevalence,
occupying one of the leading places in the structure of
morbidity and mortality of the population. In recent
years, there has been an increase in the incidence of
chronic and recurrent lung diseases among children
and adolescents (13, 22, 23, 24, 25, 26).
Despite the progress achieved in diagnosis and
treatment, diseases of the respiratory system still
occupy one of the first places in the structure of
morbidity among children and adolescents. Along with
the high level of morbidity, there is an increase in the
general population in the number of recurrent and
chronic forms of respiratory diseases, often leading to
disability. Broncho-obstructive syndrome is more often
observed in young children (20.1%). Moreover, in more
than half of children (57.5%), episodes of obstruction
recur (26, 27, 28, 29, 30, 31)
Some clinical studies show that computer aided
diagnosis (CAD) can improve the diagnostic
performance of junior radiologists. Chest X-ray is one
of the most accessible radiological methods for
screening and diagnosing various lung diseases. In
many modern hospitals, huge numbers of X-ray images
along with radiology reports are accumulated and
stored in picture archiving and communication systems
(PACS). However, it remains an unresolved question
how such a large database containing valuable imaging
data (i.e., freely labeled) can be used to support data-
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intensive deep learning paradigms to create truly large-
scale and highly accurate computer-aided diagnostic
systems (CAD).
Structural changes in the respiratory organs detected
during the analysis of biopsy samples of the bronchial
mucosa, in comparison with the study of bronchial
washings and induced sputum, can serve as the basis
for determining tissue, cellular and molecular
predictors of severe bronchial asthma, as well as
differential criteria between bronchial asthma and
chronic obstructive disease lungs (32, 33, 34).
Chest diseases and pulmonary abnormalities are the
leading causes of death according to global statistics
for 2017 (15, 35). Clinical methods for evaluating chest
diseases include chest X-ray (CXR), computed
tomography (CT), and magnetic resonance imaging
(MRI). Chest X-ray, a painless test, remains one of the
most commonly used radiological methods for
screening and diagnosing chest diseases (10, 16, 25). A
single x-ray may reveal abnormalities such as
atelectasis, cardiomegaly, effusion, pleural thickening,
and pneumonia. However, the diagnosis of chest
diseases using radiography largely depends on the skill
of the radiologist, and achieving highly accurate
diagnostic results remains a significant challenge.
Chest X-ray (CXR) is an inexpensive but effective
medical imaging technology. However, a shortage of
qualified radiologists may significantly limit the use of
this method. To improve the efficiency and accuracy of
diagnosing abnormalities in chest X-rays, new
technologies such as deep learning should be used.
Deep learning algorithms based on convolutional
neural networks (CNNs) have made significant
progress. The success of CNN in image classification
has prompted researchers to explore its usefulness as
a diagnostic tool for identifying and characterizing lung
diseases. To achieve this goal, we leverage and extend
the EfficientNet family of deep artificial neural
networks, known for their high accuracy and small size
in other applications. A collection of three datasets is
used to train the proposed approach. The results show
that the proposed approach produced a high-quality
model with an overall AUC of 0.871 and an overall
sensitivity of 79.4%, while having 5 to 30 times fewer
parameters than other architectures (36, 37).
When
comparing
high-resolution
computed
tomography studies of the lungs with histological lung
remodeling in explants with usual interstitial
pneumonia, HRCT findings were found to be typical of
UIP and HRCT of the lungs correlated best with
bronchiolectasis histologically. The NSIP pattern is
common and is associated with CT detection of HGO.
Histologic features were compared with three HRCT
findings: diagnostic appearance (UIP, probable UIP, or
incompatible with UIP), degree of honeycombing, and
degree of ground-glass opacification (38).
Acute fibrinous and organizing pneumonia is a
histologic pattern associated with the clinical
presentation of acute lung injury that differs from the
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classic histologic patterns of DAD, BOOP, or EP. Similar
to these patterns of acute lung injury, the AFOP
pattern can occur in idiopathic settings or with a
number of clinical associations. The overall mortality
rate is similar to DAD and may therefore represent a
histological variant; however, AFOP appears to have
two distinct patterns of disease progression and
outcome. The need for mechanical ventilation was the
only parameter correlated with prognosis. None of the
patients with subacute clinical course required
mechanical ventilation (39).
Medical imaging methods allow us to identify and
record abnormalities in the human div. These
techniques are critical for the assessment, diagnosis
and treatment of lung diseases. Currently, there are a
variety of research methods: ultrasound of the
respiratory organs, densitometry, digital radiography,
fluoroscopy of the lungs, CT scan of the lungs, MCT and
other research methods. Radiation diagnostics is the
main method of radiation examination in children of
the first age, which allows identifying functional and
clinical changes in the lungs (40, 41, 42).
Densitometry is a key method in multislice computed
tomography (MSCT), which helps to detail pathological
changes in the organs of the chest cavity. Chronic
progressive inflammatory process of the airways,
especially respiratory bronchioles and pulmonary
parenchyma, leads to obstructive disorders of the
ventilation function of the lungs, mucociliary
dysfunction, accumulation of neutrophils in the
respiratory tract mucosa and bronchial remodeling (43,
44, 45).
In children with pneumonia, chest X-ray (CXR) is usually
the first diagnostic test. If complications such as
abscesses or empyema occur, repeat X-rays or CT scans
are often required, increasing radiation exposure. This
retrospective study assessed the potential of radiation-
free chest MRI to detect complications initially and
later compared with chest radiography and pulmonary
ultrasound (LPUS). CXR and USL are usually sufficient,
but in cases where USL is not possible or the
combination of CXR+USL is ineffective, MRI should be
preferred. However, the use of contrast agents is not
necessary (46, 50).
USL has high internal consistency (IRR) for detecting
consolidation. Compared with CT, ultrasound and
chest x-ray (CXR) show similar sensitivity, but CXR has
greater specificity in diagnosing pneumonia (46, 17, 49,
50)
Chest X-ray (CXR) is the mainstay of diagnosis for
community-acquired pneumonia (CAP). Some authors
have recently suggested that chest ultrasound (CUS)
can effectively complement or even reliably replace X-
ray examination in the diagnosis and surveillance of
CAP. We examined the clinical utility of USG in a large
sample of patients with CAP to challenge the
hypothesis that it can replace radiography.
To improve understanding of the clinical, radiological
and pathological features of acute fibrinous and
organizing pneumonia (AFOP), the clinical data of 5
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patients with AFOP were retrospectively reviewed.
AFOP was diagnosed using percutaneous lung biopsy
guided by computed tomography (CT) of the chest.
The predominant findings on chest HRCT were bilateral
infiltrates with a diffuse and pathotype distribution. A
pathological examination revealed slightly dilated
alveolar
septa,
lymphocytic
and
plasmacytic
infiltration, as well as the presence of intra-alveolar
fibrin in the form of fibrin “balls” (organizations) inside
the alveolar spaces. No neutrophilic, eosinophilic
infiltration, or hyaline membrane formation were
observed, which was in contrast to other well-known
histologic features of acute lung injury such as diffuse
alveolar injury, cryptogenic organizing pneumonia, and
eosinophilic pneumonia. All patients received
corticosteroids and showed significant clinical and
radiological improvement. Thus, acute fibrinous and
organizing pneumonia has no specific features, and its
diagnosis depends on pathological examination.
However, whether this is a unique interstitial disease
requires further clinical investigation (47).
CONCLUSIONS
Thus, literature data show that in order to improve and
timely diagnosis and prevention of inflammatory
diseases of the bronchopulmonary system, it is
advisable to carry out radiological diagnostic methods.
Morphological studies of pleural fluid can affect the
course of diagnosis and treatment of children with
pneumonia.
Ultrasound
examination
revealed
pulmonary consolidation in more than 70% of patients
with radiographic community-acquired pneumonia,
but gave false negative results in 26.5% of cases.
Longitudinal results from some authors support the
role of USG in the surveillance of detectable lesions. In
summary, USG should be considered as an additional
tool for monitoring pneumonia rather than as a
primary imaging modality. Digital radiography
(CheXGAT) is considered more sensitive, reliable, and
highly specific. Multislice computed tomography gives
less radiation exposure to the child’s div, and in
addition, in relation to digital radiography, it is more
sensitive, specific and reliable.
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