title: Radiological patterns of primary graft dysfunction after lung transplantation evaluated by 64-multi-slice computed tomography: a descriptive study.
abstract: We evaluated the diagnostic value of high-resolution computed tomography (HRCT) images generated from 64 detector multi-slice CT scanners (HRCT(64-MSCT) imaging) in relation to primary graft dysfunction (PGD) after lung-transplantation (LUTX) in a pilot study. PGD has mortality rates ranging from 17 to 50% over a 90-day period. Detailed HRCT lung images, reconstructed using 64-MSCT, may aid diagnostic and therapeutic efforts in PGD. Thirty-two patients were scanned four times within a year post-LUTX, in a single-centre prospective study. HRCT lung images were reviewed, evaluated and scored by two observers, for ground-glass (GG) opacities, consolidation, septal thickening (ST) and pulmonary embolism. Image and PGD scores were compared in each patient. GG and consolidation changes were largely present up until 2 weeks post-LUTX, and markedly reduced by the 12th week. ST was predominantly found in patients with PGD. There were no vascular changes found at CT angiographies. The most severe cases of GG opacities and consolidation were found in patients with PGD. ST seems to be an important indicator of PGD. HRCT(64-MSCT) imaging may be a useful tool for the identification of pathological features of PGD not detected by classical evaluation in patients undergoing LUTX.
authors.affiliation: Department of Radiology X 2023, Diagnostic Imaging Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. estherokekebelmaati@gmail.com
authors.forename: Esther Okeke
authors.initials: EO
authors.lastname: Belmaati
authors.forename: Ida
authors.initials: I
authors.lastname: Steffensen
authors.forename: Claus
authors.initials: C
authors.lastname: Jensen
authors.forename: Klaus F
authors.initials: KF
authors.lastname: Kofoed
authors.forename: Jann
authors.initials: J
authors.lastname: Mortensen
authors.forename: Michael B
authors.initials: MB
authors.lastname: Nielsen
authors.forename: Martin
authors.initials: M
authors.lastname: Iversen
mesh_terms: D000328:Adult; D003718:Denmark; D005260:Female; D006801:Humans; D016040:Lung Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D010865:Pilot Projects; D011237:Predictive Value of Tests; D055031:Primary Graft Dysfunction / Q000000981:diagnostic imaging* / Q000209:etiology; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging / Q000209:etiology; D011857:Radiographic Image Interpretation, Computer-Assisted; D013997:Time Factors; D016896:Treatment Outcome