Bronchial wall measurements in patients after lung transplantation: evaluation of the diagnostic value for the diagnosis of bronchiolitis obliterans syndrome.
OBJECTIVE
To prospectively evaluate quantitative airway wall measurements of thin-section CT for the diagnosis of Bronchiolitis Obliterans Syndrome (BOS) following lung transplantation.


METHODS
In 141 CT examinations, bronchial wall thickness (WT), the wall area percentage (WA%) calculated as the ratio of the bronchial wall area and the total area (sum of bronchial wall area and bronchial lumen area) and the difference of the WT on inspiration and expiration (WTdiff) were automatically measured in different bronchial generations. The measurements were correlated with the lung function parameters. WT and WA% in CT examinations of patients with (n = 25) and without (n = 116) BOS, were compared using the unpaired t-test and univariate analysis of variance, while also considering the differing lung volumes.


RESULTS
Measurements could be performed in 2,978 bronchial generations. WT, WA%, and WTdiff did not correlate with the lung function parameters (r<0.5). The WA% on inspiration was significantly greater in patients with BOS than in patients without BOS, even when considering the dependency of the lung volume on the measurements. WT on inspiration and expiration and WA% on expiration did not show significant differences between the groups.


CONCLUSIONS
WA% on inspiration was significantly greater in patients with than in those without BOS. However, WA% measurements were significantly dependent on lung volume and showed a high variability, thus not allowing the sole use of bronchial wall measurements to differentiate patients with from those without BOS.
Hannover Medical School, Department of Radiology, Hannover, Germany.
Sabine
S
Dettmer
Hannover Medical School, Department of Radiology, Hannover, Germany.
Lars
L
Peters
Hannover Medical School, Department of Respiratory Medicine, Hannover, Germany.
Claudia
C
de Wall
Radiologie, Meander Medisch Centrum, Amersfoort, the Netherlands; Radiologie - DIAG, UMC St Radboud, Nijmegen, the Netherlands.
Cornelia
C
Schaefer-Prokop
Fraunhofer MEVIS, Bremen, Germany.
Michael
M
Schmidt
Hannover Medical School, Department of Thoracic and Cardiovascular Surgery, Hannover, Germany.
Gregor
G
Warnecke
Hannover Medical School, Department of Respiratory Medicine, Hannover, Germany.
Jens
J
Gottlieb
Hannover Medical School, Department of Radiology, Hannover, Germany.
Frank
F
Wacker
Hannover Medical School, Department of Radiology, Hannover, Germany.
Hoen-oh
HO
Shin
D000293:Adolescent; D000328:Adult; D000368:Aged; D001980:Bronchi / Q000473:pathology*; D001989:Bronchiolitis Obliterans / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008168:Lung / Q000473:pathology / Q000503:physiopathology; D016040:Lung Transplantation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012129:Respiratory Function Tests; D014057:Tomography, X-Ray Computed; D055815:Young Adult