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HRCT Features of Acute Rejection in Patients With Bilateral Lung Transplantation: The Usefulness of Lesion Distribution

Authors
 C.H. Park  ;  H.C. Paik  ;  S.J. Haam  ;  B.J. Lim  ;  M.K. Byun  ;  J.A. Shin  ;  H.J. Kim  ;  S.H. Hwang  ;  T.H. Kim 
Citation
 TRANSPLANTATION PROCEEDINGS, Vol.46(5) : 1511-1516, 2014 
Journal Title
TRANSPLANTATION PROCEEDINGS
ISSN
 0041-1345 
Issue Date
2014
MeSH
Adult ; Aged ; Female ; Graft Rejection/diagnostic imaging* ; Humans ; Lung Transplantation* ; Male ; Middle Aged ; Tomography, X-Ray Computed/methods*
Abstract
PURPOSE: This study sought to evaluate the high-resolution computed tomography (HRCT) features of acute rejection and to assess the diagnostic accuracy of HRCT for acute rejection considering distribution of lesions in patients with bilateral lung transplantation (BLT).
MATERIALS AND METHODS: Between March 2010 and June 2012, 48 transbronchial lung biopsies (TBLBs) and HRCT were performed simultaneously in 26 patients who underwent BLT. We evaluated the presence of ground glass opacity (GGO), consolidation, nodule, bronchial wall thickening, interlobular septal thickening, pleural effusion, atelectasis, bronchiectasis, and cardiomegaly on the HRCT images. The distribution of lesions was analyzed according to bilaterality or upper/lower predominance. Acute rejection was determined on the basis of the pathologic results of TBLB. We evaluated potential correlations of HRCT features with acute rejection, then assessed overall diagnostic accuracy of various HRCT features in combination to diagnose acute rejection in the transplanted lung.
RESULTS: Among the 48 TBLBs, 8 were diagnosed as acute rejection (A1, 4 cases; A2, 2 cases; and A3, 2 cases) pathologically. Two A1 rejections and one A2 rejection appeared normal on computed tomography images. Without considering the distribution of lesions, interlobular septal thickening was significantly associated with acute rejection (P = .010) only. Regarding the distribution of lesions on HRCT images, not only interlobular septal thickening but also GGO was significantly associated with acute rejection (P < .05). The sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy of the HRCT scan in the evaluation of acute rejection were 50%, 97.5%, 80%, 90.1%, and 89.6%, when the bilateral GGO and interlobular septal thickening with lower predominance were considered as the positive finding.
CONCLUSIONS: HRCT findings considering lesion distribution could be a useful tool in diagnosing acute rejection in patients with BLT.
Full Text
http://www.sciencedirect.com/science/article/pii/S0041134514001572
DOI
10.1016/j.transproceed.2013.12.060
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Tae Hoon(김태훈) ORCID logo https://orcid.org/0000-0003-3598-2529
Kim, Hyung Jung(김형중) ORCID logo https://orcid.org/0000-0003-2498-0683
Park, Chul Hwan(박철환) ORCID logo https://orcid.org/0000-0002-0004-9475
Paik, Hyo Chae(백효채) ORCID logo https://orcid.org/0000-0001-9309-8235
Byun, Min Kwang(변민광) ORCID logo https://orcid.org/0000-0003-1525-1745
Shin, Jung Ar(신정아)
Lim, Beom Jin(임범진) ORCID logo https://orcid.org/0000-0003-2856-0133
Haam, Seok Jin(함석진)
Hwang, Sung Ho(황성호)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/99475
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