Department of Paediatrics, University of Naples Federico II, Naples, Italy.
Ital J Pediatr. 2009 Aug 6;35(1):24. doi: 10.1186/1824-7288-35-24.
Primary ciliary dyskinesia (PCD) is associated with pulmonary involvement that requires periodical assessment. Chest high-resolution computed tomography (HRCT) has become the method of choice to evaluate chronic lung disease, but entails exposure to ionizing radiation. Magnetic resonance imaging (MRI) has been proposed as a potential radiation-free technique in several chest disorders. Aim of our study is to evaluate whether high-field MRI is as effective as HRCT in identifying PCD pulmonary abnormalities. We also analyzed the relationships between the severity and extension of lung disease, and functional data.
Thirteen PCD patients (8 children/5 adults; median age, 15.2 yrs) underwent chest HRCT and high-field 3T MRI, spirometry, and deep throat or sputum culture. Images were scored using a modified version of the Helbich system.
HRCT and MRI total scores were 12 (range, 6-20) and 12 (range, 5-17), respectively. Agreement between HRCT and MRI scores was good or excellent (r > 0.8). HRCT and MRI total scores were significantly related to forced vital capacity (r = -0.5, p = 0.05; and r = -0.7, p = 0.009, respectively) and forced expiratory volume at 1 second (r = -0.6, p = 0.03; and r = -0.7, p = 0.009, respectively).
Chest high-field 3T MRI appears to be as effective as HRCT in assessing the extent and severity of lung abnormalities in PCD. MRI scores might be used for longitudinal assessment and be an outcome surrogate in future studies.
原发性纤毛运动障碍(PCD)与肺部受累有关,需要定期评估。胸部高分辨率计算机断层扫描(HRCT)已成为评估慢性肺部疾病的首选方法,但需要接受电离辐射。磁共振成像(MRI)已在几种胸部疾病中被提出作为一种潜在的无辐射技术。我们的研究目的是评估高磁场 MRI 是否与 HRCT 一样有效地识别 PCD 肺部异常。我们还分析了肺部疾病的严重程度和扩展与功能数据之间的关系。
13 例 PCD 患者(8 名儿童/5 名成人;中位年龄 15.2 岁)接受了胸部 HRCT 和高磁场 3T MRI、肺量测定和深喉或痰培养。使用 Helbich 系统的改良版本对图像进行评分。
HRCT 和 MRI 总分分别为 12(范围,6-20)和 12(范围,5-17)。HRCT 和 MRI 评分之间的一致性良好或优秀(r>0.8)。HRCT 和 MRI 总分与用力肺活量(r=-0.5,p=0.05;r=-0.7,p=0.009)和 1 秒用力呼气量(r=-0.6,p=0.03;r=-0.7,p=0.009)显著相关。
胸部高磁场 3T MRI 似乎与 HRCT 一样有效,可用于评估 PCD 肺部异常的程度和严重程度。MRI 评分可用于纵向评估,并可能成为未来研究中的替代终点。