Bronchial dehiscence in lung transplantation: CT evaluation

PURPOSE: To determine the signs of bronchial dehiscence on computed tomographic (CT) scans in a select subset of lung transplant recipients. MATERIALS AND METHODS: In 23 patients who underwent single or bilateral sequential lung transplantations, CT scans were obtained for suspected or known diagnosis of bronchial dehiscence. Dehiscence was identified at bronchoscopy in 17 of the 23 patients. In four patients, the dehiscence was bilateral, resulting in 21 anastomotic dehiscences. RESULTS: CT allowed identification of a bronchial defect in 100% of the bronchoscopically proved dehiscences but only one (5%) of the 18 bronchoscopically proved intact anastomoses. CT also demonstrated extraluminal air in 100% of the bronchoscopically proved dehiscences. Only a very small amount of extraluminal air (without associated bronchial defect) was identified on CT scans in the early postoperative period in four additional patients with bronchoscopically proved intact anastomoges. CONCLUSION: CT is an easily performed and well-tolerated technique that has a high degree of sensitivity and specificity for depicting bronchial dehiscence.