利用定量计算机断层扫描评估来识别单肺移植后闭塞性细支气管炎综合征。

Utilization of Quantitative Computed Tomography Assessment to Identify Bronchiolitis Obliterans Syndrome After Single Lung Transplantation.

机构信息

Department of Lung Transplantation, Irmandade Santa Casa de Misericórdia de Porto Alegre, Av. Independência, 75, Porto Alegre, Brazil.

Medical Imaging Research Lab, LABIMED, Department of Radiology, Pavilhão Pereira Filho Hospital, Irmandade Santa Casa de Misericórdia de Porto Alegre, Av. Independência, 75, Porto Alegre, 90020160, Brazil.

出版信息

Lung. 2021 Feb;199(1):29-35. doi: 10.1007/s00408-020-00417-3. Epub 2021 Jan 13.

DOI:10.1007/s00408-020-00417-3

PMID:33439337

Abstract

OBJECTIVE

To evaluate quantitative chest computed tomography (CT) methods for the detection of air trapping (AT) and to assess its diagnostic performance for the diagnosis of bronchiolitis obliterans syndrome (BOS) in single lung transplant (SLT) patients.

METHODS

Adult patients who had a SLT at a single transplant center and underwent CT scan after transplantation were retrospectively included. CT findings of air trapping were measured by three different methods: expiratory air-trapping index (ATIexp), mean lung density on expiratory acquisition (MLDexp) and expiratory to inspiratory ratio of mean lung density (E/I-ratio(MLD). Sensitivity, specificity and diagnostic accuracy of the three methods for the detection of BOS status evaluated by serial routine measures of pulmonary function tests (gold standard) were assessed.

RESULTS

Forty-six SLT patients (52.2% females, mean age 58 ± 6 years) were included in the analysis, 12 (26%) patients with a diagnosis of BOS. Quantitative CT diagnosis of AT ranged from 26 to 35%. Sensitivity, specificity and accuracy of each method for the detection of BOS were 85.7%, 84.7% and 85.0% for ATIexp, 78.5%, 93.4% and 90.0% for MLD and 64.2%, 89.1% and 83.3% E/I-ratio(MLD), respectively.

CONCLUSION

Quantitative measures of AT obtained from standard CT are feasible and show high specificity and accuracy for the detection of BOS in SLT patients.

摘要

目的

评估定量胸部 CT（CT）检测空气滞留（AT）的方法，并评估其在单肺移植（SLT）患者中诊断闭塞性细支气管炎综合征（BOS）的诊断性能。

方法

回顾性纳入在单个移植中心接受 SLT 并在移植后进行 CT 扫描的成年患者。通过三种不同的方法测量空气滞留的 CT 表现：呼气性空气滞留指数（ATIexp）、呼气性采集时的平均肺密度（MLDexp）和平均肺密度的呼气与吸气比值（E/I-ratio(MLD)。评估三种方法检测 BOS 状态的敏感性、特异性和诊断准确性，通过常规肺功能测试的系列评估（金标准）。

结果

共纳入 46 例 SLT 患者（52.2%为女性，平均年龄 58±6 岁），其中 12 例（26%）患者诊断为 BOS。定量 CT 诊断 AT 的范围为 26%至 35%。每种方法检测 BOS 的敏感性、特异性和准确性分别为 ATIexp 为 85.7%、84.7%和 85.0%，MLD 为 78.5%、93.4%和 90.0%，E/I-ratio(MLD)为 64.2%、89.1%和 83.3%。