Conventional High-resolution CT Versus Contiguous Multidetector CT in the Detection of Bronchiolitis Obliterans Syndrome in Lung Transplant Recipients

    loading  Checking for direct PDF access through Ovid

Abstract

Objective

To compare the detection rate of pulmonary abnormalities between conventional high-resolution computed tomography (HRCT) and high-resolution multidetector computed tomography (MDCT) in lung transplant recipients and to correlate a composite computed tomography (CT) score with bronchiolitis obliterans syndrome (BOS) stage.

Methods

Twenty-four lung transplant recipients (12 single/12 double lung transplants, 13 males/11 females, mean age: 53 y, range: 28 to 71) underwent contiguous 16-slice high-resolution MDCT of the lungs at maximal inspiration and maximal expiration. Eight reformatted image sets were reconstructed: (i) contiguous 1-mm slice MDCT image set in the transverse, sagittal, and coronal image planes at maximal inspiration; (ii) contiguous 1-mm slice MDCT image set in the transverse, sagittal, and coronal image planes at maximal expiration; (iii) conventional HRCT image set of 1-mm slices every 10 mm at maximal inspiration; and (iv) conventional expiratory HRCT of 1-mm slices at 3 selected levels at maximal expiration. Individual pulmonary abnormalities were added to give a composite CT score. Individual abnormalities and the composite CT score were correlated with BOS stage, as based on functional testing of airflow obstruction, for each of the 8 image sets.

Results

Transverse, sagittal, and coronal MDCT correlated significantly with BOS stage (R=0.46, 0.49, 0.52, respectively), whereas conventional HRCT did not. Multiple regression analysis demonstrated that transverse MDCT was the only independent predictor of BOS stage (R2=0.33, P<0.01). Interobserver agreement for composite CT scores for HRCT, transverse, sagittal, and coronal MDCT were R=0.89, 0.87, 0.83 and 0.80, respectively. Interobserver agreement for individual abnormalities was better with MDCT than with conventional HRCT.

Conclusions

In lung transplant recipients, high-resolution MDCT detects significantly more pulmonary abnormalities and has better interobserver agreement than conventional HRCT and is an independent predictor of BOS stage.

Related Topics

    loading  Loading Related Articles