Bronchiolitis Obliterans on High-Resolution CT

Eber, Corey; Stark, Paul C.; Bertozzi, Paul

doi:10.1097/00004728-199311000-00003

Cited by 49 publications

(21 citation statements)

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“…This lack of correlation of HRCT changes with lung function may be related to the patchy nature of the disease [24]. Low-attenuation areas on CT/HRCT scans represent a combination of air trapping and hypoxic vasoconstriction from hypoventilation secondary to small airways obstruction [24][25][26][27]. This would explain the concomitant vascular attenuation seen in 4 of our patients.…”

Section: Resultsmentioning

confidence: 84%

“…This radiological sign was the main HRCT feature of BO syndrome in both BMT and lung transplantation patients in a recent comparative study [21]. Other reported CT/HRCT findings include patchy low-and high-attenuation areas, branching opacities and mosaic oligaemia [22,23,26,27]. Air trapping featured as accentuated areas of low attenuation on expiratory scans has been described [26].…”

Section: Resultsmentioning

confidence: 87%

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High-Resolution Computed Tomography of Bronchiolitis Obliterans Syndrome after Bone Marrow Transplantation

Ooi¹,

Peh²,

1998

Respiration

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High-resolution computed tomography (HRCT) has been described to be useful in assessing bronchiolitis obliterans (BO) syndrome in the transplanted lung. Currently, BO syndrome is diagnosed if lung function deterioration shows persistent or progressive irreversible airflow obstruction, with FEV₁ of less than 80% of baseline values, without clinical evidence of infection. The aim of this study is to assess the value of HRCT in evaluating BO syndrome after allogenic bone marrow transplantation (BMT). Fourteen HRCT scans were performed in 6 women and 3 men with moderately severe irreversible airflow obstruction and a clinical diagnosis of BO syndrome after BMT. Two patients had normal HRCT scans. In the remaining 7 patients, 7 of 11 HRCT scans were abnormal, with non-specific findings of bronchial dilatation (1), consolidation (2), hypoattenuated areas (4) and vascular attenuation (4). In comparison with the consistency of positive HRCT findings of BO syndrome in transplanted lungs, HRCT surveillance for BO syndrome in post-BMT patients with clinically established disease is of limited value, unless other pulmonary complications such as opportunistic infections are to be excluded.

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Section: Resultsmentioning

confidence: 84%

Section: Resultsmentioning

confidence: 87%

High-Resolution Computed Tomography of Bronchiolitis Obliterans Syndrome after Bone Marrow Transplantation

Ooi¹,

Peh²,

1998

Respiration

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“…In 13 of 15 a pattern of "patchy irregular areas of high and low attenuation in variable proportions, accentuated in expiration" was recorded. This, and a report of two cases by EBER et al [86], were the first reports to identify regional inhomogeneity of the density of the lung parenchyma as the key CT feature of constrictive bronchiolitis.…”

Section: High-resolution Computed Tomography Of Individual Features Omentioning

confidence: 72%

Small airways diseases: detection and insights with computed tomography

Dm¹

2001

Eur Respir J

146

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Diseases affecting the small airways are difficult to detect by traditional diagnostic tests. Widespread involvement is needed before symptoms and abnormalities on pulmonary function testing or chest radiography become apparent. Obstruction of the bronchioles may be detected indirectly by computed tomography (CT) because regional under-ventilation results in reduced perfusion which in turn is shown as a mosaic attenuation pattern of the lung parenchyma. When there is inflammation of the bronchioles with accompanying exudate, the airways may become directly visible on CT, for example in cases of diffuse panbronchiolitis.Quantification of the various morphological features of small airways disease is possible from CT images and this increased precision has aided investigations of structure/function relationships.An understanding of the pathology and microscopic distribution of disease in relation to the airways allows some prediction of the likely computed tomography appearances in this wide spectrum of conditions, and thus helps to refine the differential diagnosis.

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“…Additionally, in some patients, the evidence of air trapping on expiratory scans is the only sign of lung abnormality [7][8][9]. However, scans taken at end expiration sometimes show a lack of changes in patients with severe and widespread involvement of the small airways [10]. Breath holding at end expiration is particularly difficult for some patients with bronchiolar disorders.…”

Section: Introductionmentioning

confidence: 99%

Expiratory computed tomographic techniques: A cause of a poor rate of change in lung volume

Morikawa

Okada

Mori

2014

Radiol Phys Technol

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Ninety-nine patients (29 males and 70 females; mean age, 57.1 years; range, 22-81 years) were included in this study to evaluate the factors affecting smaller lung volume changes in expiratory high-resolution computed tomography performed to depict air trapping. All patients underwent inspiratory and expiratory chest thin-section CT examinations and pulmonary function tests. Air trapping on CT images was graded subjectively. All variables (age, sex, diagnosis, pulmonary function index, and air trapping score) were compared with the degree of change in lung volume between the inspiratory and expiratory CT examinations. The variables affecting a lower degree of volume change were vital capacity, forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1.0), and the FEV1.0/FVC ratio. Bronchiolitis obliterans was the dominant diagnosis in patients with insufficient degrees of breath holding and in patients with negative air trapping scores despite an abnormal air trapping index. An insufficient degree of lung changes between inspiration and expiration on CT examinations represented bronchiolitis obliterans, which resulted in low FEV1.0 and FEV1.0/FVC values. Changes in the time gap from the announcement of exhalation and breath holding to the start of scanning most effectively indicated air trapping in patients with bronchiolar disorders.

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Bronchiolitis Obliterans on High-Resolution CT

Cited by 49 publications

References 0 publications

High-Resolution Computed Tomography of Bronchiolitis Obliterans Syndrome after Bone Marrow Transplantation

High-Resolution Computed Tomography of Bronchiolitis Obliterans Syndrome after Bone Marrow Transplantation

Small airways diseases: detection and insights with computed tomography

Expiratory computed tomographic techniques: A cause of a poor rate of change in lung volume

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