Value of high-resolution computed tomography in routine evaluation of lung transplantation recipients during development of bronchiolitis obliterans syndrome

• Published in: The Journal of heart and lung transplantation Vol. 15; no. 6; p. 587
• Main Authors: Ikonen, T, Kivisaari, L, Harjula, A L, Lehtola, A, Heikkilä, L, Kinnula, V L, Kyösola, K, Savola, J, Sipponen, J, Verkkala, K, Mattila, S P
• Format: Journal Article
• Language: English
• Published: United States 01.06.1996
• Subjects: Adult; Bronchiolitis Obliterans - diagnostic imaging; Bronchiolitis Obliterans - etiology; Bronchiolitis Obliterans - physiopathology; Chronic Disease; Disease Progression; Female; Follow-Up Studies; Forced Expiratory Volume; Graft Rejection - diagnostic imaging; Graft Rejection - etiology; Graft Rejection - physiopathology; Humans; Lung - diagnostic imaging; Lung Transplantation - adverse effects; Lung Transplantation - diagnostic imaging; Male; Middle Aged; Retrospective Studies; Sensitivity and Specificity; Syndrome; Tomography, X-Ray Computed
• ISSN: 1053-2498

Chronic rejection is a major long-term complication after lung transplantation. The purpose of our study was to evaluate the role of repeated high-resolution computed tomographic examinations in monitoring the development of bronchiolitis obliterans syndrome after lung transplantation. A total of 126 high-resolution computed tomographic examination in 13 lung transplant recipients was analyzed. During a mean follow-up period of 23 months, bronchiolitis obliterans syndrome developed in eight of the patients. A scoring system from 0 to 10 based on the number of chronic changes on high-resolution computed tomography was developed, and the score of each patient was compared with decline in the forced expiratory volume in 1 second and maximal forced expiratory flow rate of 50% of the forced vital capacity. The score of chronic changes, measured at 1 year after transplantation, correlated inversely with the values of forced expiratory volume in 1 second and maximal forced expiratory flow rate at 50% of the forced vital capacity (p < 0.05). Stage I bronchiolitis obliterans syndrome was associated with scores of 4 to 6 (mean 5.0), stage 2 with scores of 6 to 9 (mean 7.0), and stage 3 with scores of 6 to 9 (mean 7.7). The sensitivity of high-resolution computed tomography was 93% and its specificity was 92% when five chronic changes were used as a cutoff level. The progress of chronic changes on high-resolution computed tomography occurs concurrently with the development of bronchiolitis obliterans syndrome. High-resolution computed tomography may provide additional morphologic information for noninvasive evaluation of chronic lung rejection.