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Bronchiolitis obliterans after lung transplantation: detection using expiratory HRCT.
Chest 1998; 113(2):365-70Chest

Abstract

OBJECTIVE

The objective of this study was to determine if air trapping, as detected on expiratory high-resolution CT (HRCT), is useful as an indicator of bronchiolitis obliterans (BO) in lung transplant recipients.

MATERIALS AND METHODS

Corresponding inspiratory and expiratory HRCT images at five different levels and spirometry were obtained in 21 lung transplant recipients. Eleven patients had BO proved by transbronchial biopsy specimens; the remaining 10 patients had no pathologic or functional evidence of airways disease. Two "blinded" observers assessed the inspiratory images for the presence of bronchiectasis and mosaic pattern of lung attenuation, and the expiratory images for presence and extent of air trapping. Statistical comparison of the frequency of HRCT findings between patients with and without BO was performed using Fisher's Exact Test.

RESULTS

On inspiratory images, bronchiectasis and mosaic pattern of lung attenuation were present in 4 (36%) and 7 (64%) of 11 patients with BO, and 2 (20%) and 1 (10%) of 10 patients without BO (p>0.05 and p<0.05), respectively. The sensitivity, specificity, and accuracy of bronchiectasis and mosaic pattern for BO were 36%, 80%, and 57%, and 64%, 90%, and 70%, respectively. On expiratory images, air trapping was found in 10 of 11 (91%) patients with BO compared to 2 of 10 (20%) patients without BO (p<0.002). Air trapping was found to have a sensitivity of 91%, specificity of 80%, and accuracy of 86% for BO. Air trapping was identified in one patient with BO who had normal results of baseline spirometric function tests.

CONCLUSION

Air trapping, as detected on expiratory HRCT, was the most sensitive and accurate radiologic indicator of BO in the lung transplant population.

Authors+Show Affiliations

Department of Radiology, Stanford University Medical Center, Calif 94305-5105, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

9498953

Citation

Leung, A N., et al. "Bronchiolitis Obliterans After Lung Transplantation: Detection Using Expiratory HRCT." Chest, vol. 113, no. 2, 1998, pp. 365-70.
Leung AN, Fisher K, Valentine V, et al. Bronchiolitis obliterans after lung transplantation: detection using expiratory HRCT. Chest. 1998;113(2):365-70.
Leung, A. N., Fisher, K., Valentine, V., Girgis, R. E., Berry, G. J., Robbins, R. C., & Theodore, J. (1998). Bronchiolitis obliterans after lung transplantation: detection using expiratory HRCT. Chest, 113(2), pp. 365-70.
Leung AN, et al. Bronchiolitis Obliterans After Lung Transplantation: Detection Using Expiratory HRCT. Chest. 1998;113(2):365-70. PubMed PMID: 9498953.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Bronchiolitis obliterans after lung transplantation: detection using expiratory HRCT. AU - Leung,A N, AU - Fisher,K, AU - Valentine,V, AU - Girgis,R E, AU - Berry,G J, AU - Robbins,R C, AU - Theodore,J, PY - 1998/3/14/pubmed PY - 1998/3/14/medline PY - 1998/3/14/entrez SP - 365 EP - 70 JF - Chest JO - Chest VL - 113 IS - 2 N2 - OBJECTIVE: The objective of this study was to determine if air trapping, as detected on expiratory high-resolution CT (HRCT), is useful as an indicator of bronchiolitis obliterans (BO) in lung transplant recipients. MATERIALS AND METHODS: Corresponding inspiratory and expiratory HRCT images at five different levels and spirometry were obtained in 21 lung transplant recipients. Eleven patients had BO proved by transbronchial biopsy specimens; the remaining 10 patients had no pathologic or functional evidence of airways disease. Two "blinded" observers assessed the inspiratory images for the presence of bronchiectasis and mosaic pattern of lung attenuation, and the expiratory images for presence and extent of air trapping. Statistical comparison of the frequency of HRCT findings between patients with and without BO was performed using Fisher's Exact Test. RESULTS: On inspiratory images, bronchiectasis and mosaic pattern of lung attenuation were present in 4 (36%) and 7 (64%) of 11 patients with BO, and 2 (20%) and 1 (10%) of 10 patients without BO (p>0.05 and p<0.05), respectively. The sensitivity, specificity, and accuracy of bronchiectasis and mosaic pattern for BO were 36%, 80%, and 57%, and 64%, 90%, and 70%, respectively. On expiratory images, air trapping was found in 10 of 11 (91%) patients with BO compared to 2 of 10 (20%) patients without BO (p<0.002). Air trapping was found to have a sensitivity of 91%, specificity of 80%, and accuracy of 86% for BO. Air trapping was identified in one patient with BO who had normal results of baseline spirometric function tests. CONCLUSION: Air trapping, as detected on expiratory HRCT, was the most sensitive and accurate radiologic indicator of BO in the lung transplant population. SN - 0012-3692 UR - https://www.unboundmedicine.com/medline/citation/9498953/Bronchiolitis_obliterans_after_lung_transplantation:_detection_using_expiratory_HRCT_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0012-3692(16)32416-3 DB - PRIME DP - Unbound Medicine ER -