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Pierrealain Gevenois - One of the best experts on this subject based on the ideXlab platform.
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regional heterogeneity of Air Trapping at expiratory thin section ct of patients with bronchiolitis potential implications for dose reduction and ct protocol planning
Radiology, 2008Co-Authors: Alexander A Bankier, Marc Estenne, Sheida Mehrain, Daniela Kienzl, Michael Weber, Pierrealain GevenoisAbstract:Purpose: To prospectively determine whether the regional distribution of Air Trapping in patients with suspected or overt bronchiolitis is heterogeneous, and to determine the effect that a simulated reduction of computed tomographic (CT) sections and of scanned anatomic regions would have on the assessment of the extent of Air Trapping. Materials and Methods: For this Ethical Committee–approved study, multi–detector row CT (collimation, 4 × 1 mm; rotation time, 0.5 second; 140 kVp; and 80 effective mAs) was performed in 47 lung transplant recipients (23 women, 24 men; mean age, 41 years ± 12 [standard deviation]; 18 without bronchiolitis, 18 with potential bronchiolitis, and 11 with bronchiolitis, as determined by lung function measurements). Images were reconstructed with a thickness of 1 mm at an increment of 10 mm. The extent of Air Trapping in the upper, middle, and lower lung regions was correlated. Differences between regions and the interaction between patients and regions were tested with an analy...
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Air Trapping in heart lung transplant recipients variability of anatomic distribution and extent at sequential expiratory thin section ct
Radiology, 2003Co-Authors: Alexander A Bankier, Marc Estenne, Alain Van Muylem, Pietro Scillia, Viviane De Maertelaer, Pierrealain GevenoisAbstract:PURPOSE: To evaluate the intrapatient reproducibility of the extent and anatomic distribution of Air Trapping at sequential expiratory thin-section computed tomographic (CT) examinations in heart-lung transplant recipients. MATERIALS AND METHODS: Nineteen heart-lung transplant recipients (eight with and 11 without bronchiolitis obliterans syndrome [BOS]) underwent three expiratory CT examinations within 1 hour. Residual volumes were measured at CT. Anatomic distribution and extent of Air Trapping were scored by two observers at two independent readings, and the reproducibility of observations was calculated for each feature. CT examination results were compared by using an analysis of variance that took into account interobserver and BOS and non-BOS effects. The Spearman rank correlation coefficient was calculated to test the association between variability of residual volumes and variability of the extent of Air Trapping. RESULTS: Residual volumes did not significantly differ between the three CT examina...
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bronchiolitis obliterans syndrome in heart lung transplant recipients diagnosis with expiratory ct
Radiology, 2001Co-Authors: Alexander A Bankier, Marc Estenne, Alain Van Muylem, Christiane Knoop, Pierrealain GevenoisAbstract:PURPOSE: To determine the test performance and longitudinal evolution of Air Trapping for diagnosing bronchiolitis obliterans syndrome (BOS). MATERIALS AND METHODS: Over 7 years, 111 combined inspiratory and expiratory computed tomographic examinations were performed in eight healthy control subjects and 38 heart-lung transplant recipients. Functional impAirment was assessed with the BOS classification. Receiver operating characteristic (ROC) analysis was performed to determine the optimal threshold of Air Trapping to distinguish between patients with and those without BOS and to compute sensitivity and specificity for diagnosing BOS. RESULTS: The extent of Air Trapping increased with BOS severity (P =.001). A threshold of 32% of Air Trapping is optimal for distinguishing between patients with and those without BOS and provides a sensitivity of 83%, a specificity of 89%, and an accuracy of 88%. The prevalence of BOS and positive predictive value of Air Trapping increased with postoperative time, but the negative predictive value of Air Trapping remained high throughout the study. Patients without BOS who had Air Trapping exceeding 32% of the parenchyma were at significantly increased risk of developing BOS (P =.004). CONCLUSION: At the threshold of 32%, Air Trapping is sensitive, specific, and accurate for diagnosing BOS. Patients with Air Trapping below 32% are unlikely to have BOS. Air Trapping exceeding 32% may be an early indicator of future BOS.
Warren S Sandberg - One of the best experts on this subject based on the ideXlab platform.
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endobronchial blocker dislodgement leading to pulseless electrical activity
Anesthesia & Analgesia, 2005Co-Authors: Warren S SandbergAbstract:This is a report of a case in which an endobronchial blocker was dislodged, leading to severe Air Trapping and a brief episode of pulseless electrical activity. Bronchial blockade for lung deflation was successfully instituted during emergency repAir of a ruptured descending aortic aneurysm. During
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endobronchial blocker dislodgement leading to pulseless electrical activity
Anesthesia & Analgesia, 2005Co-Authors: Warren S SandbergAbstract:This is a report of a case in which an endobronchial blocker was dislodged, leading to severe Air Trapping and a brief episode of pulseless electrical activity. Bronchial blockade for lung deflation was successfully instituted during emergency repAir of a ruptured descending aortic aneurysm. During a period not involving manipulation of aortic cross-clamps, end-tidal CO2 decreased precipitously to zero and Airway pressures increased markedly, followed by equalization of intracardiac pressures. Prompt deflation of the endobronchial blocker balloon reversed the problem. We hypothesize that when surgical manipulation dislodged the bronchial blocker into the tracheal position, leading to profound Air Trapping as successive, stacked tidal volumes were forced distal to the blocker.
David A Lynch - One of the best experts on this subject based on the ideXlab platform.
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presence of Air Trapping and mosaic attenuation on chest computed tomography predicts survival in chronic hypersensitivity pneumonitis
Annals of the American Thoracic Society, 2017Co-Authors: Jonathan H Chung, David A Lynch, Xi Zhan, Mengshu Cao, Tilman L Koelsch, Diana Gomez C Manjarres, Kevin K Brown, Gloria Russell, Evans Fernandez R PerezAbstract:Rationale: Significant heterogeneity of computed tomography (CT) presentation exists within chronic hypersensitivity pneumonitis (HP). There are limited data aimed at delineating the prognostic value of specific CT features, distribution, and patterns in chronic HP.Objectives: To examine whether the presence of CT mosaic attenuation (MA) and Air Trapping (AT), and the distribution or patterns of fibrosis impact survival in subjects with chronic HP.Methods: We retrospectively identified 110 consecutively enrolled, well-characterized, biopsy-proven adult subjects with chronic HP between 1982 and 2015 from the National Jewish Health interstitial lung disease research database. The first available CT scan of diagnostic quality from each subject was formally evaluated for specific CT findings associated with chronic HP and for overall CT pattern. A Cox proportional hazards model was used to identify independent predictors in time-to-death analysis, and bootstrap analysis was performed for internal model valida...
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dnah5 is associated with total lung capacity in chronic obstructive pulmonary disease
Respiratory Research, 2014Co-Authors: Merrylynn N Mcdonald, Harvey O. Coxson, Peter J. Castaldi, Gary M Hunninghake, Per Bakke, Nathaniel Marchetti, David A Lomas, David A Lynch, James D. CrapoAbstract:Background Chronic obstructive pulmonary disease (COPD) is characterized by expiratory flow limitation, causing Air Trapping and lung hyperinflation. Hyperinflation leads to reduced exercise tolerance and poor quality of life in COPD patients. Total lung capacity (TLC) is an indicator of hyperinflation particularly in subjects with moderate-to-severe Airflow obstruction. The aim of our study was to identify genetic variants associated with TLC in COPD.
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quantitative computed tomography in chronic obstructive pulmonary disease
Journal of Thoracic Imaging, 2013Co-Authors: David A Lynch, Mustafa L AlqaisiAbstract:Quantitative CT is increasingly used to quantify the features of COPD, specifically emphysema, Air Trapping, and Airway abnormality. For quantification of emphysema, the density mask technique is most widely used, with threshold on the order of-950 HU, but percentile cutoff may be less sensitive to volume changes. Sources of variation include depth of inspiration, scanner make and model, technical parameters, and cigarette smoking. On expiratory CT, Air Trapping may be quantified by evaluating the % of lung volume less than a given threshold (e.g. -856 HU), by comparing lung volumes and attenuation on expiration and inspiration, or more recently by co-registering inspiratory and expiratory CT scans. These indices all correlate well with the severity of physiologic Airway obstruction. By constructing a three-dimensional model of the Airway from volumetric CT, it is possible to measure dimensions (external and internal diameters, and Airway wall thickness) of segmental and subsegmental Airways orthogonal to their long axes. Measurement of Airway parameters correlates with severity of Airflow obstruction and with history of COPD exacerbation.
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relationships between Airflow obstruction and quantitative ct measurements of emphysema Air Trapping and Airways in subjects with and without chronic obstructive pulmonary disease
American Journal of Roentgenology, 2013Co-Authors: Joyce D Schroeder, John D Newell, Alexander S Mckenzie, Jordan Zach, Carla Wilson, Douglas Curraneverett, Douglas Stinson, David A LynchAbstract:OBJECTIVE. This study evaluates the relationships between quantitative CT (QCT) and spirometric measurements of disease severity in cigarette smokers with and without chronic obstructive pulmonary disease (COPD). MATERIALS AND METHODS. Inspiratory and expiratory CT scans of 4062 subjects in the Genetic Epidemiology of COPD (COPDGene) Study were evaluated. Measures examined included emphysema, defined as the percentage of low-attenuation areas ≤ –950 HU on inspiratory CT, which we refer to as “LAA-950I”; Air Trapping, defined as the percentage of low-attenuation areas ≤ –856 HU on expiratory CT, which we refer to as “LAA-856E”; and the inner diameter, inner and outer areas, wall area, Airway wall thickness, and square root of the wall area of a hypothetical Airway of 10-mm internal perimeter of segmental and subsegmental Airways. Correlations were determined between spirometry and several QCT measures using statistics software (SAS, version 9.2). RESULTS. QCT measurements of low-attenuation areas correlate...
Alexander A Bankier - One of the best experts on this subject based on the ideXlab platform.
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regional heterogeneity of Air Trapping at expiratory thin section ct of patients with bronchiolitis potential implications for dose reduction and ct protocol planning
Radiology, 2008Co-Authors: Alexander A Bankier, Marc Estenne, Sheida Mehrain, Daniela Kienzl, Michael Weber, Pierrealain GevenoisAbstract:Purpose: To prospectively determine whether the regional distribution of Air Trapping in patients with suspected or overt bronchiolitis is heterogeneous, and to determine the effect that a simulated reduction of computed tomographic (CT) sections and of scanned anatomic regions would have on the assessment of the extent of Air Trapping. Materials and Methods: For this Ethical Committee–approved study, multi–detector row CT (collimation, 4 × 1 mm; rotation time, 0.5 second; 140 kVp; and 80 effective mAs) was performed in 47 lung transplant recipients (23 women, 24 men; mean age, 41 years ± 12 [standard deviation]; 18 without bronchiolitis, 18 with potential bronchiolitis, and 11 with bronchiolitis, as determined by lung function measurements). Images were reconstructed with a thickness of 1 mm at an increment of 10 mm. The extent of Air Trapping in the upper, middle, and lower lung regions was correlated. Differences between regions and the interaction between patients and regions were tested with an analy...
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Air Trapping in heart lung transplant recipients variability of anatomic distribution and extent at sequential expiratory thin section ct
Radiology, 2003Co-Authors: Alexander A Bankier, Marc Estenne, Alain Van Muylem, Pietro Scillia, Viviane De Maertelaer, Pierrealain GevenoisAbstract:PURPOSE: To evaluate the intrapatient reproducibility of the extent and anatomic distribution of Air Trapping at sequential expiratory thin-section computed tomographic (CT) examinations in heart-lung transplant recipients. MATERIALS AND METHODS: Nineteen heart-lung transplant recipients (eight with and 11 without bronchiolitis obliterans syndrome [BOS]) underwent three expiratory CT examinations within 1 hour. Residual volumes were measured at CT. Anatomic distribution and extent of Air Trapping were scored by two observers at two independent readings, and the reproducibility of observations was calculated for each feature. CT examination results were compared by using an analysis of variance that took into account interobserver and BOS and non-BOS effects. The Spearman rank correlation coefficient was calculated to test the association between variability of residual volumes and variability of the extent of Air Trapping. RESULTS: Residual volumes did not significantly differ between the three CT examina...
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bronchiolitis obliterans syndrome in heart lung transplant recipients diagnosis with expiratory ct
Radiology, 2001Co-Authors: Alexander A Bankier, Marc Estenne, Alain Van Muylem, Christiane Knoop, Pierrealain GevenoisAbstract:PURPOSE: To determine the test performance and longitudinal evolution of Air Trapping for diagnosing bronchiolitis obliterans syndrome (BOS). MATERIALS AND METHODS: Over 7 years, 111 combined inspiratory and expiratory computed tomographic examinations were performed in eight healthy control subjects and 38 heart-lung transplant recipients. Functional impAirment was assessed with the BOS classification. Receiver operating characteristic (ROC) analysis was performed to determine the optimal threshold of Air Trapping to distinguish between patients with and those without BOS and to compute sensitivity and specificity for diagnosing BOS. RESULTS: The extent of Air Trapping increased with BOS severity (P =.001). A threshold of 32% of Air Trapping is optimal for distinguishing between patients with and those without BOS and provides a sensitivity of 83%, a specificity of 89%, and an accuracy of 88%. The prevalence of BOS and positive predictive value of Air Trapping increased with postoperative time, but the negative predictive value of Air Trapping remained high throughout the study. Patients without BOS who had Air Trapping exceeding 32% of the parenchyma were at significantly increased risk of developing BOS (P =.004). CONCLUSION: At the threshold of 32%, Air Trapping is sensitive, specific, and accurate for diagnosing BOS. Patients with Air Trapping below 32% are unlikely to have BOS. Air Trapping exceeding 32% may be an early indicator of future BOS.
Jafar Aslani - One of the best experts on this subject based on the ideXlab platform.
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Tracheobronchomalacia and Air Trapping after Mustard Gas Exposure
2013Co-Authors: Mostafa Ghanei, Farhad Akbari Moqadam, Mehdi Mir Mohammad, Jafar AslaniAbstract:Rationale: Mustard gas primarily affects the eyes, skin, and particularly the respiratory tract. Tracheobronchomalacia (TBM) and Air Trapping are often observed in high-resolution computerized tomography (HRCT) scans of the chest of mustard gas–exposed patients. Objectives: To examine the frequency and severity of TBM in a group of Iranian wartime mustard gas–exposed victims, and to investigate the correlation between TBM and Air Trapping in these cases. Materials and Methods: Chest HRCT films obtained from 300 randomly selected subjects who had been exposed to mustard gas 15.5 yr previously were reviewed to determine the existence of TBM and Air Trapping. The HRCT films of a healthy control group were also analyzed for comparison. Results: Out of 300 reviewed cases, 13 had TBM. From these 13 TBM cases, 11 (85%) showed Air Trapping with mean score of 5.5. In the control group, 5 (25%) of 20 subjects showed Air Trapping, with mean score of 0.6. The total Air Trapping was significantly higher in the TBM group (p � 0.001). There was an association between the severity of tracheomalacia and Air Trapping in the TBM group (p � 0.01, r � 0.69), but no association was observed between severity of bronchomalacia and Air Trapping. Conclusion: The results show that Air Trapping and TBM are correlated, both as long-term sequelae in mustard gas–exposed cases. Because Air Trapping is highly suggestive of bronchiolitis obliterans, we conclude that both bronchiolitis obliterans and TBM are caused by a single underlying process affecting small and large Airways, respectively, in this group of patients
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tracheobronchomalacia and Air Trapping after mustard gas exposure
American Journal of Respiratory and Critical Care Medicine, 2006Co-Authors: Mostafa Ghanei, Farhad Akbari Moqadam, Mehdi Mir Mohammad, Jafar AslaniAbstract:Rationale: Mustard gas primarily affects the eyes, skin, and particularly the respiratory tract. Tracheobronchomalacia (TBM) and Air Trapping are often observed in high-resolution computerized tomography (HRCT) scans of the chest of mustard gas–exposed patients.Objectives: To examine the frequency and severity of TBM in a group of Iranian wartime mustard gas–exposed victims, and to investigate the correlation between TBM and Air Trapping in these cases.Materials and Methods: Chest HRCT films obtained from 300 randomly selected subjects who had been exposed to mustard gas 15.5 yr previously were reviewed to determine the existence of TBM and Air Trapping. The HRCT films of a healthy control group were also analyzed for comparison.Results: Out of 300 reviewed cases, 13 had TBM. From these 13 TBM cases, 11 (85%) showed Air Trapping with mean score of 5.5. In the control group, 5 (25%) of 20 subjects showed Air Trapping, with mean score of 0.6. The total Air Trapping was significantly higher in the TBM group ...
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bronchiolitis obliterans following exposure to sulfur mustard chest high resolution computed tomography
European Journal of Radiology, 2004Co-Authors: Mostafa Ghanei, Mehdi Mir Mohammad, Majid Mokhtari, Jafar AslaniAbstract:Abstract Background: Pulmonary complications are known to occur in over half of the patients exposed to sulfur mustard (SM). Chemical weapons of mass destruction (WMD) including SM were used by Iraq during Iran–Iraq war between 1983 and 1989. We undertook this study to evaluate the chest high resolution computerized tomography (HRCT) as a diagnostic tool in patients with documented exposure to SM and chronic respiratory symptoms. Method: The medical records of 155 patients exposed to SM during Iran–Iraq war and suffered respiratory complications were reviewed. Chest HRCTs of these patients were examined. Ten healthy controls with no history of exposure to HD were matched for age, gender, and chest HRCT protocol applied. Results: Fifty chest HRCTs of these patients were randomly selected for this study. The most frequent findings were; Air Trapping 38 (76%), bronchiectasis 37 (74%), mosaic parenchymal attenuation (MPA) 36 (72%), irregular and dilated major Airways 33 (66%) bronchial wall thickening (BWT) 45 (90%), and interlobular septal wall thickening (SWT) 13 (26%), respectively. Air Trapping in one patient (10%) was the only positive finding in the control group. Conclusions: Chest HRCT findings of bronchiectasis, Air Trapping, MPA, SWT, and BWT were seen in our patients 15 years after exposure to HD. These findings suggest the diagnosis of bronchiolitis obliterans (BO). We did not encounter chest HRCT features consistent with pulmonary fibrosis.