Hannover Medical School, Department of Respiratory Medicine, Hannover, Germany.
Ther Adv Respir Dis. 2010 Feb;4(1):3-11. doi: 10.1177/1753465809356293. Epub 2009 Dec 30.
In the first 6 months following lung transplantation, the most frequently occurring complications are infection, acute rejection and anastomotic dysfunction. The utility of vibration response imaging (VRI) lung images in assisting with the detection of these complications was evaluated.
The study aimed to evaluate if VRI is a good, non-invasive method of detecting clinical problems in lung transplant (LTx) recipients during early follow-up.
Between 06/2006 and 03/2007 all LTx patients who received transplants during the preceding 6 months at the Hannover Medical School received baseline VRI at enrollment with subsequent reassessment in combination with standard follow-up at 1, 3 and 6 months thereafter. The resulting images were analysed by two blinded reviewers.
Fifty-five lung transplant recipients were enrolled in the study, with 49 patients successfully completing follow-up. Device operability and patient participation occurred without significant problems. High numbers of abnormal scans were detected. According to the clinical diagnosis, 29 patients (59.2 %) were stable at all four visits. Twenty clinical problems occurred (e.g., infections, rejections, obstructions, unknown deterioration). Agreement with clinical interpretation of rejections and infections was poor. Central airway obstruction (CAO) was detected in 80% by both reviewers. Accuracy in detecting obstructions was 89%; positive predicted value and negative predicted value were 80% and 90%, respectively.
The VRI system is a non-invasive easy-to-use method with technical success and good image quality. The high number of abnormal scans makes interpretation following LTx difficult. VRI was unable to detect deterioration in graft function with the exception of ventilation disorders like central airway complications.
肺移植后最初 6 个月，最常发生的并发症是感染、急性排斥反应和吻合口功能障碍。评估了振动反应成像（VRI）肺图像在协助检测这些并发症中的作用。
本研究旨在评估 VRI 是否是一种检测肺移植（LTx）受者早期随访中临床问题的良好、非侵入性方法。
2006 年 6 月至 2007 年 3 月，汉诺威医学院在前 6 个月内接受移植的所有 LTx 患者在入组时接受基线 VRI，随后与标准随访相结合，在 1、3 和 6 个月后进行重新评估。由两名盲审员分析生成的图像。
55 例肺移植受者入组研究，49 例患者成功完成随访。设备可操作性和患者参与均无明显问题。检测到大量异常扫描。根据临床诊断，29 例（59.2%）患者在所有 4 次就诊时均稳定。共发生 20 例临床问题（如感染、排斥反应、阻塞、不明原因恶化）。与排斥反应和感染的临床解释的一致性较差。两位审阅者均发现 80%的中央气道阻塞（CAO）。阻塞的检测准确率为 89%；阳性预测值和阴性预测值分别为 80%和 90%。
VRI 系统是一种非侵入性、易于使用的方法，具有技术成功和良好的图像质量。异常扫描数量较多，使 LTx 后的解释变得困难。VRI 无法检测到移植物功能的恶化，除了通气障碍，如中央气道并发症。
