title: Diagnosis of bronchiolitis obliterans in heart-lung transplantation patients: importance of bronchial dilatation on CT.
abstract: 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.
authors.affiliation: Department of Radiology, Stanford University Medical Center, CA 94305-5105.
authors.forename: D
authors.initials: D
authors.lastname: Lentz
authors.forename: C J
authors.initials: CJ
authors.lastname: Bergin
authors.forename: G J
authors.initials: GJ
authors.lastname: Berry
authors.forename: C
authors.initials: C
authors.lastname: Stoehr
authors.forename: J
authors.initials: J
authors.lastname: Theodore
mesh_terms: 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