Abstract:
HTML
Purpose: To determine the diagnostic capabilities of dynamic high resolution electron beam computed tomography for diagnosing bronchiolitis obliterans syndrome (BOS) in lung transplant recipients.
Methods and Materials: At the time of follow-up examinations after lung transplantation, 52 patients (24 female, mean age: 46±15 years, range: 13 - 72 years) were examined by dynamic high resolution electron beam computed tomography. Visual signs of small airway disease were assessed and compared with lung function. For numerical analysis, the mean lung attenuation and its standard deviation were determined and compared with the course of lung function tests.
Results: Upon correlation of visual signs of small airway disease with the clinical course during follow up, advanced degrees of expiratory inhomogeneity were significantly associated with BOS (p=0.02). Using this criterion, 8/9 patients with BOS at the time of the exam were detected, and 2/4 patients who progressed to BOS during follow up were detected. The specificity was 26/39. Upon correlation of lung attenuation with the clinical course during follow up, it was found that patients who progressed to BOS during follow up displayed a reduced attenuation when compared to all other courses of lung function (ANOVA, p<0.0001), and that patients with manifest BOS had a higher attenuation than all other courses (p=0.006 - p<0.0001). Lung homogeneity of patients who either progressed to BOS or had manifest BOS at the time of the CT examination was significantly lower than in patients who remained stable (p<0.0001).
Conclusion: Dynamic high-resolution electron-beam CT of lung transplant recipients correlates well with lung function criteria of BOS at the time of the CT examination and with the prediction of future progression to BOS. In particular, visually or numerically determined parenchymal inhomogeneity may serve as a diagnostic sign for BOS, while numerically determined lung hyperinflation can be used to predict the progression to BOS.
Knollmann MD, F,
Bronchiolitis Obliterans in Lung Transplant Recipients: Diagnosis with Dynamic High-Resolution Electron Beam CT. Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL.
http://archive.rsna.org/2003/3103689.html
