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European Radiology
Published in: European Radiology 8/2020

01-08-2020 | Computed Tomography | Chest

Quantitative CT analysis for bronchiolitis obliterans in perinatally HIV-infected adolescents—comparison with controls and lung function data

Authors: Christian A. Barrera, Anne-Marie du Plessis, Hansel J. Otero, Sana Mahtab, Leah N. Githinji, Heather J. Zar, Xiaowei Zhu, Savvas Andronikou

Published in: European Radiology | Issue 8/2020

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Abstract

Objective

To compare quantitative chest CT parameters in perinatally HIV-infected adolescents with and without bronchiolitis obliterans compared with HIV-uninfected controls and their association with lung function measurements.

Materials and Methods

Seventy-eight (41 girls) HIV-infected adolescents with a mean age of 13.8 ± 1.65 years and abnormal pulmonary function tests in the prospective Cape Town Adolescent Antiretroviral Cohort underwent contrast-enhanced chest CT on inspiration and expiration. Sixteen age-, sex-, and height-matched non-infected controls were identified retrospectively. Fifty-one HIV-infected adolescents (28 girls) displayed mosaic attenuation on expiration suggesting bronchiolitis obliterans. Pulmonary function tests were collected. The following parameters were obtained: low- and high-attenuation areas, mean lung density, kurtosis, skewness, ventilation heterogeneity, lung mass, and volume.

Results

HIV-infected adolescents showed a significantly higher mean lung density, ventilation heterogeneity, mass, and high- and low-attenuation areas compared with non-infected individuals. Kurtosis and skewness were significantly lower as well. HIV-infected adolescents with bronchiolitis obliterans had a significantly lower kurtosis and skewness compared with those without bronchiolitis obliterans. Lung mass and volume showed the strongest correlations with forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), and alveolar volume. Low-attenuation areas below – 950 HU and ventilation heterogeneity showed the strongest correlation with FEV1/FVC (range, − 0.51 to − 0.34) and forced expiratory flow between 25 and 75% of FVC (range, − 0.50 to − 0.35).

Conclusion

Quantitative chest CT on inspiration is a feasible technique to differentiate perinatally HIV-infected adolescents with and without bronchiolitis obliterans. Quantitative CT parameters correlate with spirometric measurements of small-airway disease.

Key Points

• Perinatally HIV-infected adolescents showed a more heterogeneous attenuation of the lung parenchyma with a higher percentage of low- and high-attenuation areas compared with non-infected patients.
• Kurtosis and skewness are able to differentiate between HIV-infected adolescents with and without bronchiolitis obliterans using an inspiratory chest CT.
• Quantitative CT parameters of the chest correlate significantly with pulmonary function test. Low-attenuation areas and ventilation heterogeneity are particularly associated with spirometric parameters related to airway obstruction.
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Metadata
Title
Quantitative CT analysis for bronchiolitis obliterans in perinatally HIV-infected adolescents—comparison with controls and lung function data
Authors
Christian A. Barrera
Anne-Marie du Plessis
Hansel J. Otero
Sana Mahtab
Leah N. Githinji
Heather J. Zar
Xiaowei Zhu
Savvas Andronikou
Publication date
01-08-2020
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 8/2020
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-020-06789-7

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