BACKGROUND: Regional analysis by computed tomography (CT) is an attractive technique to interpret lung patterns after transplantation (LTx). We evaluated the application of CT functional mask derived parameters to determine whether development of primary graft dysfunction (PGD) is associated with short and/or long-term postoperative evidences of pulmonary function alterations. METHODS: A total of 38 patients who underwent bilateral LTx were evaluated at 24, 48 and 72 hours after the end of surgery to establish PGD occurrence and grading. CT scans at 3 and 12 months after LTx were analyzed to measure specific gas volume (SVg) changes normalized on expiratory SVgEXP of the whole lung (ΔSVg/SVgEXP) and to obtain functional masks of density variation, namely maps of low ventilation (LV), consolidation (C), air trapping (AT) and healthy parenchyma (H). RESULTS: Our main result was the evidence of a marked decrease in ΔSVg/SVgEXP in all subjects, irrespectively on PGD, at each time point after LTx, indicating a high degree of ventilation defects versus healthy. High percentages of LV were found in all subjects while percentages of AT and C were negligible. CONCLUSIONS: We demonstrate that quantification of ventilation defects by CT functional mask offers insights into the correlation between PGD and pulmonary function after LTx at short and mid-term.
BACKGROUND: Regional analysis by computed tomography (CT) is an attractive technique to interpret lung patterns after transplantation (LTx). We evaluated the application of CT functional mask derived parameters to determine whether development of primary graft dysfunction (PGD) is associated with short and/or long-term postoperative evidences of pulmonary function alterations. METHODS: A total of 38 patients who underwent bilateral LTx were evaluated at 24, 48 and 72 hours after the end of surgery to establish PGD occurrence and grading. CT scans at 3 and 12 months after LTx were analyzed to measure specific gas volume (SVg) changes normalized on expiratory SVgEXP of the whole lung (ΔSVg/SVgEXP) and to obtain functional masks of density variation, namely maps of low ventilation (LV), consolidation (C), air trapping (AT) and healthy parenchyma (H). RESULTS: Our main result was the evidence of a marked decrease in ΔSVg/SVgEXP in all subjects, irrespectively on PGD, at each time point after LTx, indicating a high degree of ventilation defects versus healthy. High percentages of LV were found in all subjects while percentages of AT and C were negligible. CONCLUSIONS: We demonstrate that quantification of ventilation defects by CT functional mask offers insights into the correlation between PGD and pulmonary function after LTx at short and mid-term.
Authors: Esther Okeke Belmaati; Martin Iversen; Klaus F Kofoed; Michael B Nielsen; Jann Mortensen Journal: Interact Cardiovasc Thorac Surg Date: 2012-03-09
Authors: H O Coxson; R M Rogers; K P Whittall; Y D'yachkova; P D Paré; F C Sciurba; J C Hogg Journal: Am J Respir Crit Care Med Date: 1999-03 Impact factor: 21.405
Authors: Daniel Kreisel; Alexander S Krupnick; Varun Puri; Tracey J Guthrie; Elbert P Trulock; Bryan F Meyers; G Alexander Patterson Journal: J Thorac Cardiovasc Surg Date: 2010-11-19 Impact factor: 5.209
Authors: Esther Okeke Belmaati; Ida Steffensen; Claus Jensen; Klaus F Kofoed; Jann Mortensen; Michael B Nielsen; Martin Iversen Journal: Interact Cardiovasc Thorac Surg Date: 2012-02-28
Authors: Jason D Christie; Jeffrey S Sager; Stephen E Kimmel; Vivek N Ahya; Christina Gaughan; Nancy P Blumenthal; Robert M Kotloff Journal: Chest Date: 2005-01 Impact factor: 9.410
Authors: Caterina Salito; Andrea Aliverti; David S Gierada; Gaetan Deslée; Richard A Pierce; Peter T Macklem; Jason C Woods Journal: Radiology Date: 2009-07-31 Impact factor: 11.105
Authors: Erin Angel; Nazanin Yaghmai; Cecilia Matilda Jude; John J DeMarco; Christopher H Cagnon; Jonathan G Goldin; Cynthia H McCollough; Andrew N Primak; Dianna D Cody; Donna M Stevens; Michael F McNitt-Gray Journal: AJR Am J Roentgenol Date: 2009-11 Impact factor: 3.959
Authors: Bryan A Whitson; Matthew E Prekker; Cynthia S Herrington; Timothy P M Whelan; David M Radosevich; Marshall I Hertz; Peter S Dahlberg Journal: J Heart Lung Transplant Date: 2007-10 Impact factor: 10.247