Diagnosis of bronchiolitis obliterans in heart-lung transplantation patients: importance of bronchial dilatation on CT.
OBJECTIVE
The purpose of this study was to evaluate the significance of bronchial dilatation identified on high-resolution CT scans obtained after heart-lung transplantation. Bronchial dilatation has been identified on pathologic specimens and on high-resolution CT scans of patients with severe bronchiolitis obliterans after lung transplantation, but this finding has not previously been systematically studied as a manifestation of this complication.


METHODS
We studied the high-resolution CT scans of 16 patients who had had heart and lung transplantation at least 1 year before, and compared the percentage of dilated bronchi with evidence of small airways disease shown on pulmonary function tests.


RESULTS
We found a close correlation between the percentage of bronchi in the lower lobes that were dilated and the percent predicted forced expiratory volume in 1 sec, forced vital capacity, and forced expiratory flow between 25% and 75% of vital capacity. No other feature identified on high-resolution CT scans correlated with pulmonary function abnormalities.


CONCLUSIONS
We conclude that dilatation of the lower lobe bronchi is a good indicator of bronchiolitis obliterans in this population, and that the percentage of dilated bronchi generally increases with increasing pulmonary dysfunction.
Lentz
D
D
Department of Radiology, Stanford University Medical Center, CA 94305-5105.
Bergin
C J
CJ
Berry
G J
GJ
Stoehr
C
C
Theodore
J
J
D001706:Biopsy; D001989:Bronchiolitis Obliterans / Q000000981:diagnostic imaging* / Q000209:etiology / Q000473:pathology; D001995:Bronchography / Q000379:methods*; D004108:Dilatation, Pathologic / Q000000981:diagnostic imaging / Q000209:etiology; D016041:Heart-Lung Transplantation / Q000009:adverse effects*; D006801:Humans; D011856:Radiographic Image Enhancement; D012129:Respiratory Function Tests; D014057:Tomography, X-Ray Computed