Diagnosis of bronchiolitis obliterans in heart-lung transplantation patients: importance of bronchial dilatation on CT

AJR Am J Roentgenol. 1992 Sep;159(3):463-7. doi: 10.2214/ajr.159.3.1503006.


Objective: The purpose of this study was to evaluate the significance of bronchial dilatation identified on high-resolution CT scans obtained after heart-lung transplantation. Bronchial dilatation has been identified on pathologic specimens and on high-resolution CT scans of patients with severe bronchiolitis obliterans after lung transplantation, but this finding has not previously been systematically studied as a manifestation of this complication.

Materials and methods: We studied the high-resolution CT scans of 16 patients who had had heart and lung transplantation at least 1 year before, and compared the percentage of dilated bronchi with evidence of small airways disease shown on pulmonary function tests.

Results: We found a close correlation between the percentage of bronchi in the lower lobes that were dilated and the percent predicted forced expiratory volume in 1 sec, forced vital capacity, and forced expiratory flow between 25% and 75% of vital capacity. No other feature identified on high-resolution CT scans correlated with pulmonary function abnormalities.

Conclusion: We conclude that dilatation of the lower lobe bronchi is a good indicator of bronchiolitis obliterans in this population, and that the percentage of dilated bronchi generally increases with increasing pulmonary dysfunction.

MeSH terms

  • Biopsy
  • Bronchiolitis Obliterans / diagnostic imaging*
  • Bronchiolitis Obliterans / etiology
  • Bronchiolitis Obliterans / pathology
  • Bronchography / methods*
  • Dilatation, Pathologic / diagnostic imaging
  • Dilatation, Pathologic / etiology
  • Heart-Lung Transplantation / adverse effects*
  • Humans
  • Radiographic Image Enhancement
  • Respiratory Function Tests
  • Tomography, X-Ray Computed*