急性慢性阻塞性肺疾病加重期：3T磁共振成像对肺区域灌注的评估——初步经验

Acute COPD exacerbation: 3 T MRI evaluation of pulmonary regional perfusion--preliminary experience.

作者信息

Sergiacomi Gianluigi, Taglieri Amedeo, Chiaravalloti Antonio, Calabria Eros, Arduini Silvia, Tosti Daniela, Citraro Daniele, Pezzuto Gabriella, Puxeddu Ermanno, Simonetti Giovanni

机构信息

Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiation Therapy, PTV Foundation, "Tor Vergata" Hospital, University of Rome "Tor Vergata", Rome, Italy; Department of Biomedicine and Prevention, University of Rome "Tor Vergata", via montpellier 1, Rome, Italy.

Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiation Therapy, PTV Foundation, "Tor Vergata" Hospital, University of Rome "Tor Vergata", Rome, Italy.

出版信息

Respir Med. 2014 Jun;108(6):875-82. doi: 10.1016/j.rmed.2014.04.002. Epub 2014 Apr 14.

DOI:10.1016/j.rmed.2014.04.002

PMID:24780717

Abstract

OBJECTIVES

To compare pulmonary perfusion parameters by means of dynamic perfusion magnetic resonance in patients affected by chronic obstructive pulmonary disease (COPD), during and after acute exacerbation.

METHODS

Fifteen patients were successfully evaluated with perfusional MRI during an acute exacerbation of COPD and upon clinical stabilization. Inclusion criteria were a PaCO2 > 45 mmHg and respiratory acidosis (arterial blood pH < 7.35) at admittance.

RESULTS

In the acute phase a reduction of pulmonary blood flow (PBF) and pulmonary blood volume (PBV), and a significant prolonging of the mean transit time (MTT) and time to peak (TTP) were observed in all patients. In the stabilization phase a significant increase of PBF and PBV and a significant reduction of MTT and TTP were observed in 6 patients; no significant variations were observed in the other 9 patients.

CONCLUSION

3D time-resolved contrast-enhanced MRI allows quantitative evaluation of pulmonary regional perfusion in patients affected by COPD, identifying patients in which perfusion defects are resolved in the clinical-stabilization phase. This technique might allow the identification of patients in whom vasospasm may be the main responsible of pulmonary hypoperfusion during acute COPD exacerbation, with potential advantages on the clinical management of these patients.

摘要