Bronchiolitis obliterans syndrome in lung transplant recipients: can thin-section CT findings predict disease before its clinical appearance?

التفاصيل البيبلوغرافية
العنوان:	Bronchiolitis obliterans syndrome in lung transplant recipients: can thin-section CT findings predict disease before its clinical appearance?
المؤلفون:	Konen E; Department of Medical Imaging, Toronto General Hospital, University Health Network, Ontario, Canada. konen@zahav.net.il, Gutierrez C, Chaparro C, Murray CP, Chung T, Crossin J, Hutcheon MA, Paul NS, Weisbrod GL
المصدر:	Radiology [Radiology] 2004 May; Vol. 231 (2), pp. 467-73.
نوع المنشور:	Journal Article
اللغة:	English
بيانات الدورية:	Publisher: Radiological Society of North America Country of Publication: United States NLM ID: 0401260 Publication Model: Print Cited Medium: Print ISSN: 0033-8419 (Print) Linking ISSN: 00338419 NLM ISO Abbreviation: Radiology Subsets: MEDLINE
أسماء مطبوعة:	Publication: Easton, PA : Radiological Society of North America Original Publication: [Illinois?] : Radiological Society of North America, [1923]-
مواضيع طبية MeSH:	Bronchiolitis Obliterans/diagnostic imaging , Lung Transplantation/adverse effects , Tomography, X-Ray Computed/*methods, Adolescent ; Adult ; Aged ; Bronchiolitis Obliterans/etiology ; Child ; Female ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Syndrome ; Time Factors
مستخلص:	Purpose: To determine whether there are thin-section computed tomographic (CT) features that predict bronchiolitis obliterans syndrome (BOS) in lung transplant recipients before the clinical appearance and during the early stages of the disease. Materials and Methods: Two hundred ninety-eight thin-section CT scans obtained in 26 lung transplant recipients who did (study group) and 26 lung transplant recipients who did not (control group) develop BOS were reviewed for the presence of mosaic perfusion, bronchiectasis, bronchial wall thickening, and air trapping. BOS was defined by using the recently revised definition of the International Society for Heart and Lung Transplantation. CT scans obtained in the BOS group were divided into three groups: Group A consisted of the last scans obtained before the clinical appearance of BOS; groups B and C consisted of, respectively, the first and last scans obtained after the clinical appearance of BOS. Scans obtained in the control group were acquired during similar posttransplantation periods and matched to scans in each BOS group. Sensitivity, specificity, and positive and negative predictive values were calculated separately for each subgroup. The optimal threshold for each thin-section CT-depicted abnormality was defined by using receiver operating characteristics analysis. Results: The sensitivities of air trapping for the diagnosis of BOS during the periods in which the scans in groups A, B, and C were obtained were 50%, 44%, and 64%, respectively; specificities were 80%, 100%, and 80% respectively. Sensitivities of mosaic perfusion were 4%, 20%, and 36%, respectively; specificities were 100%, 96%, and 96%, respectively. Sensitivities of bronchiectasis were 25%, 24%, and 32%, respectively; specificities were 80%, 80%, and 96%, respectively. Sensitivities of bronchial wall thickening were 4%, 24%, and 40%, respectively; specificities were 96%, 84%, and 80%, respectively. Air trapping was seen intermittently in nine (43%) of 21 patients with CT scans that depicted this finding at least once. Conclusion: The value of the finding of air trapping before the clinical appearance and during the early stages of BOS is lower than has been previously reported. When using the recently revised criteria for BOS, the role of thin-section CT as a screening test to evaluate patients with lung transplants appears to be limited.
تواريخ الأحداث:	Date Created: 20040507 Date Completed: 20040629 Latest Revision: 20161124
رمز التحديث:	20240628
DOI:	10.1148/radiol.2312030563
PMID:	15128992
قاعدة البيانات:	MEDLINE

الوصف
تدمد:	0033-8419
DOI:	10.1148/radiol.2312030563