Table 3 An overview of three scoring systems for chest radiography in cystic fibrosis, adapted from the original publications. The modification of the Chrispin-Norman score from 1982 [19] also included enlarged hilar lymph nodes in the score, in this table included in the parenchyma score. In the Wisconsin scoring system [18] each scoring component is weighted, the range for each component score was calculated by using the formula given in the publication
Radiography scoring systems | Chrispin-Norman (1974) [13] Modified 1982 [15] Modified 2005 [21] | Brasfield (1979) [11] | |
|---|---|---|---|
Scoring area | 4 zones | Both lungs | - central/peripheral (peribronchial thickening) - 4 quadrants (bronchiectasis, nodules) - 5 lobes (opacities, atelectasis) |
Scoring components/scoring levels, scoring range | |||
Increased lung volume | Chest configuration [13] - Sternal bowing - Diaphragm depression - Spinal kyphosis Overinflation [21] - Diaphragm depression - Chest wall shape - Lung fields Each finding is scored 0–2 Range 0−6 | Air trapping - sternal bowing - depression of diaphragm - and/or thoracic kyphosis 0–4 Range 0−4 | Hyperinflation - diaphragm contour - retrosternal lucency - heart position - sternal bowing - kyphosis 0–1 (Range 0–12.5) |
Bronchial wall thickening | Bronchial line shadows Each zone 0–2 Range 0−8 | Linear markings 0–4 Range 0−4 | Peribronchial thickening 0–1 (Range 0–12.5) |
Bronchiectasis and mucus plugging | - Ring shadows 0–2 - Mottled shadows 0–2 Range 0- 16 | Nodular cystic lesions 0–4 Range 0−4 | - Bronchiectasis 0–1 (Range 0–31) - Nodular branching opacities 0–1 (Range 0–12.5) |
Parenchyma | Large shadows Each zone 0–2 Range 0–8 (Enlarged hilar shadows [15] 0–2 × 2 Range 0–4) | Large lesions 0–5 Range 0−5 | - Large opacities 0–1 (Range 0–12.5) - Atelectasis 0–1 (Range 0–19) |
Overall severity | 0−5 Range 0−5 | ||
Total score | Maximum 42 [15] | Maximum 22 | Maximum 100 p - Multiplicative model [18] - Additive model [20] |