Bronchiectasis detected with thin-section CT as a predictor of chronic lung allograft rejection.

Abstract

The diagnosis of chronic rejection relies on the degree of impairment of pulmonary function. When the diagnosis is only suspected on the basis of minimal impairment, CT can aid in the diagnosis of rejection by depicting early pulmonary changes.

Restrictive allograft syndrome (RAS): A novel form of chronic lung allograft dysfunction

“…Consistent with previous reports, [17][18][19] BOS showed significant bronchial dilation, mosaic attenuation, and air trapping. RAS patients showed characteristics of interstitial lung disease.…”

The airway epithelium is a direct source of matrix degrading enzymes in bronchiolitis obliterans syndrome

“…In fact, it is incorrect to say that the large airways are spared, because bronchiectasis is a common feature of latestage disease. 29,30 Our data support the idea that production of matrix-degrading enzymes during dysregulated repair of the large airway epithelium may lead to disruption of the basement membrane and submucosal structures, eventually leading to the airway wall dilatation characteristic of bronchiectasis. However, because we could not demonstrate geographic restriction of MMP or TIMP expression, it is unclear why the small airway region undergoes contrary changes.…”

Functional lung imaging using hyperpolarized gas MRI

“…Noninvasive imaging is an attractive means of detecting onset and progression of disease. HR CT is routinely used to evaluate the location and extent of bronchiectasis and fibrosis associated with BO, but anatomical changes are not readily detected until the disease is significantly progressed (113,114). Functional measures, such as volume of air trapping on expiratory HR CT posttransplant, appear to be more sensitive and specific for BO detection (115).…”