Sergiacomi Gianluigi, Taglieri Amedeo, Chiaravalloti Antonio, Calabria Eros, Arduini Silvia, Tosti Daniela, Citraro Daniele, Pezzuto Gabriella, Puxeddu Ermanno, Simonetti Giovanni
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.
Respir Med. 2014 Jun;108(6):875-82. doi: 10.1016/j.rmed.2014.04.002. Epub 2014 Apr 14.
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.
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.
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.
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.
通过动态灌注磁共振成像比较慢性阻塞性肺疾病（COPD）患者在急性加重期及之后的肺灌注参数。
15例患者在COPD急性加重期及临床病情稳定时成功接受了灌注MRI评估。纳入标准为入院时PaCO2>45 mmHg且存在呼吸性酸中毒（动脉血pH<7.35）。
急性期所有患者均出现肺血流量（PBF）和肺血容量（PBV）降低，平均通过时间（MTT）和达峰时间（TTP）显著延长。在稳定期，6例患者的PBF和PBV显著增加，MTT和TTP显著降低；其他9例患者未观察到显著变化。
三维时间分辨对比增强MRI能够对COPD患者的肺区域灌注进行定量评估，识别出在临床稳定期灌注缺陷得以解决的患者。该技术可能有助于识别在COPD急性加重期血管痉挛可能是肺灌注不足主要原因的患者，对这些患者的临床管理具有潜在优势。
