Thin-section Computed Tomography findings before and after azithromycin treatment of neutrophilic reversible lung allograft dysfunction
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Pim A. de Jong & Robin Vos & Geert M. Verleden & Bart M. Vanaudenaerde & Johny A. Verschakelen
- چاپ و سال / کشور: 2011
Description
Objectives Recently a novel subgroup of bronchiolitis obliterans syndrome (BOS) has been described in patients after lung transplantation with high neutrophil counts in broncho-alveolar lavage and recovery of lung functional decline with azithromycin treatment. We aimed to describe the thin-section computed tomography (CT) findings of these neutrophilic reversible allograft dysfunction (NRAD) patients before and after azithromycin. Methods A cohort of 100 lung transplant recipients with BOS were treated with azithromycin and underwent lung function testing, broncho-alveolar lavage and CT before azithromycin treatment and during follow-up. The 200 CT data sets were scored for bronchial dilatation, mucus plugging, centrilobular abnormalities, airway wall thickening, consolidation, ground glass and end-expiratory air trapping. Results NRAD was characterized by more centrilobular abnormalities on CT (p=0.03 for prevalence and p=0.06 for severity) compared to non-responders. At follow-up NRAD patients showed improvement in all CT abnormalities including air trapping, but the degree of improvement in all CT abnormalities was significantly different between responders and non-responders (who showed progression of bronchus dilatation, consolidation and air trapping). Conclusions Within BOS patients those with NRAD differ from azithromycin non-responders by more centrilobular abnormalities on CT before azithromycin and improvement in bronchus dilatation, consolidation and air trapping during treatment.
Eur Radiol DOI 10.1007/s00330-011-2224-1 Received: 6 April 2011 / Revised: 24 May 2011 / Accepted: 12 June 2011
