Diagnosis of pulmonary complications associated with lung transplantation in children: Value of CT vs histopathologic studies

OBJECTIVE. The purpose of this study was to compare the CT findings with those of histopathologic studies to determine if CT can be used to differentiate between the pulmonary parenchymal complications that occur in children after lung transplantation. MATERIALS AND METHODS. Seventeen children who underwent 14 bilateral and three single lung transplantations were studied. The study population included nine girls and eight boys 2-16 years old (mean, 11 years). CT scans were examined for evidence of interlobular septal thickening, air-space consolidation, ground-glass opacities, nodules, bronchial dilatation, decreased vascularity, and pleural effusions. Thirty-one histopathologic diagnoses from 25 transbronchial biopsies were available for comparison with CT findings. The final histopathologic diagnoses were acute rejection (n = 10), chronic rejection (n = 6), infection (n = 7), nonspecific findings (n = 4), and no abnormalities (n = 4). RESULTS. No significant difference was noted in the CT findings in patients with acute rejection, chronic rejection, and infection. CONCLUSION. In this limited study of children, CT findings were not helpful in differentiating between the different parenchymal pulmonary complications associated with lung transplantation. On the basis of these preliminary findings, we recommend caution in suggesting specific diagnoses based on CT scans without histologic proof.