Plathow Christian, Klopp Michael, Schoebinger Max, Thieke Christian, Fink Christian, Puderbach Michael, Ley Sebastian, Weber Marc-Andre, Sandner Alexandra, Claussen Claus D, Herth Felix, Tuengerthal Siegfried, Meinzer Hans-Peter, Kauczor Hans-Ulrich
Department of Diagnostic Radiology, Eberhard-Karls University, Tuebingen, Germany.
Invest Radiol. 2006 May;41(5):443-8. doi: 10.1097/01.rli.0000208222.03256.ba.
To monitor lung motion in patients with malignant pleural mesothelioma (MPM) before and after chemotherapy (CHT) using 2-dimensional (2D) and 3-dimensional (3D) dynamic MRI (dMRI) in comparison with spirometry.
Twenty-two patients with MPM were examined before CHT, as well as after 3 and 6 CHT cycles (3 months and 6 months) using 2D dMRI (trueFISP; 3 images/s) and 3D dMRI (FLASH 3D, 1 slab (52 slices)/s) using parallel imaging in combination with view-sharing technique. Maximum craniocaudal lung dimensions (2D) and lung volumes (3D) were monitored, separated into the tumor-bearing and nontumor-bearing hemithorax. Vital capacity (VC) was measured for comparison using spirometry.
Using 2D technique, there was a significant difference between the tumor-bearing and the nontumor-bearing hemithorax before CHT (P < 0.01) and after 3 CHT cycles (P < 0.05), whereas difference was not significant in the second control. In the tumor-bearing hemithorax, mobility increased significantly from the status before versus after 3 CHT cycles (4.1 +/- 1.1 cm vs. 4.8 +/- 1.4 cm, P < 0.05). Using 3D technique, at maximum inspiration, the volume of the tumor-bearing hemithorax was 0.6 +/- 0.4 L and of the nontumor-bearing hemithorax 1.25 +/- 0.4 L before CHT. In the follow-up exams, these volumes changed to 1.05 +/- 0.4 L (P < 0.05) and 1.4 +/- 0.5 L, respectively. Using spirometry, there was no significant change in VC (1.9 +/- 0.4 L vs. 2.2 +/- 0.7 L vs. 2.2 +/- 0.9 L).
dMRI is capable of monitoring changes in lung motion and volumetry in patients with MPM not detected by global spirometry. Thus, dMRI is proposed for use as a further measure of therapy response.
使用二维（2D）和三维（3D）动态磁共振成像（dMRI）监测恶性胸膜间皮瘤（MPM）患者化疗（CHT）前后的肺运动，并与肺活量测定法进行比较。
22例MPM患者在CHT前以及CHT 3个周期和6个周期后（3个月和6个月）接受检查，使用2D dMRI（真稳态进动快速成像；每秒3幅图像）和3D dMRI（快速扰相梯度回波三维成像，每秒1层（52层）），并行成像结合视图共享技术。监测最大头尾方向肺尺寸（2D）和肺容积（3D），分为患侧和健侧半胸。使用肺活量测定法测量肺活量（VC）以进行比较。
使用2D技术，CHT前患侧和健侧半胸之间存在显著差异（P < 0.01），CHT 3个周期后也存在显著差异（P < 0.05），而第二次对照时差异不显著。在患侧半胸，运动度从CHT 3个周期前到后显著增加（4.1±1.1 cm对4.8±1.4 cm，P < 0.05）。使用3D技术，在最大吸气时，CHT前患侧半胸的容积为0.6±0.4 L，健侧半胸为1.25±0.4 L。在随访检查中，这些容积分别变为1.05±0.4 L（P < 0.05）和1.4±0.5 L。使用肺活量测定法，VC无显著变化（1.9±0.4 L对2.2±0.7 L对2.2±0.9 L）。
dMRI能够监测MPM患者肺运动和容积的变化，而这些变化是常规肺活量测定法无法检测到的。因此，建议将dMRI用作评估治疗反应的进一步手段。
