PURPOSE: To assess the potential use of spirometrically gated lung computed tomographic (CT) findings in the diagnosis of bronchiolitis obliterans syndrome after Jung transplantation.
MATERIALS AND METHODS: Forty-nine lung transplant recipients were examined at least 8 months after surgery with spirometrically gated thin-section CT of the lung. In addition to visual signs of small-airway disease at CT, mean lung attenuation and the SD were numerically determined and compared with the results of lung function testing at the time of the CT examination and 1 year later by using factorial analysis of variance.
RESULTS: Mean lung attenuation was significantly lower in patients who developed bronchiolitis obliterans syndrome within 1 year after the CT study (-837 HU � 3) than in patients with persistent normal lung function (-812 HU � 3, P < .001). With an optimal threshold, sensitivity was 69%, specificity was 71%, and accuracy was 84%. Visual analysis did not significantly contribute to the prognostic power of CT.
CONCLUSION: Spirometrically gated CT measurements of lung attenuation can be used to predict the onset of bronchiolitis obliterans syndrome after lung transplantation.