Pennati Francesca, Quirk James D, Yablonskiy Dmitriy A, Castro Mario, Aliverti Andrea, Woods Jason C
From the Department of Electronics, Information, and Bioengineering, Politecnico di Milano, Piazza L. da Vinci 32, 20133 Milan, Italy (F.P., A.A.); Mallinckrodt Institute of Radiology (J.D.Q., D.A.Y.), Department of Internal Medicine (M.C.), and Department of Physics (J.C.W.), Washington University School of Medicine, St Louis, Mo; and Center for Pulmonary Imaging Research, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio (J.C.W.).
Radiology. 2014 Nov;273(2):580-90. doi: 10.1148/radiol.14132470. Epub 2014 Jun 15.
To introduce a method based on multivolume proton (hydrogen [(1)H]) magnetic resonance (MR) imaging for the regional assessment of lung ventilatory function, investigating its use in healthy volunteers and patients with obstructive lung disease and comparing the outcome with the outcome of the research standard helium 3 ((3)He) MR imaging.
The institutional review board approved the HIPAA-compliant protocol, and informed written consent was obtained from each subject. Twenty-six subjects, including healthy volunteers (n = 6) and patients with severe asthma (n = 11) and mild (n = 6) and severe (n = 3) emphysema, were imaged with a 1.5-T whole-body MR unit at four lung volumes (residual volume [ RV residual volume ], functional residual capacity [ FRC functional residual capacity ], 1 L above FRC functional residual capacity [ FRC+1 L 1 L above FRC ], total lung capacity [ TLC total lung capacity ]) with breath holds of 10-11 seconds, by using volumetric interpolated breath-hold examination. Each pair of volumes were registered, resulting in maps of (1)H signal change between the two lung volumes. (3)He MR imaging was performed at FRC+1 L 1 L above FRC by using a two-dimensional gradient-echo sequence. (1)H signal change and (3)He signal were measured and compared in corresponding regions of interest selected in ventral, intermediate, and dorsal areas.
In all volunteers and patients combined, proton signal difference between TLC total lung capacity and RV residual volume correlated positively with (3)He signal (correlation coefficient R(2) = 0.64, P < .001). Lower (P < .001) but positive correlation results from (1)H signal difference between FRC functional residual capacity and FRC+1 L 1 L above FRC (R(2) = 0.44, P < .001). In healthy volunteers, (1)H signal changes show a higher median and interquartile range compared with patients with obstructive disease and significant differences between nondependent and dependent regions.
Findings in this study demonstrate that multivolume (1)H MR imaging, without contrast material, can be used as a biomarker for regional ventilation, both in healthy volunteers and patients with obstructive lung disease.
介绍一种基于多容积质子(氢[¹H])磁共振(MR)成像的肺通气功能区域评估方法,研究其在健康志愿者和阻塞性肺疾病患者中的应用,并将结果与研究标准的氦3(³He)MR成像结果进行比较。
机构审查委员会批准了符合健康保险流通与责任法案(HIPAA)的方案,并获得了每位受试者的书面知情同意。26名受试者,包括健康志愿者(n = 6)、重度哮喘患者(n = 11)以及轻度(n = 6)和重度(n = 3)肺气肿患者,使用1.5-T全身MR设备,通过容积内插屏气检查,在四个肺容积(残气量[RV残气量]、功能残气量[FRC功能残气量]、高于FRC功能残气量1 L处[FRC + 1 L高于FRC]、肺总量[TLC肺总量])下进行屏气10 - 11秒的成像。对每对容积进行配准,得到两个肺容积之间的¹H信号变化图。通过二维梯度回波序列在高于FRC 1 L处(FRC + 1 L)进行³He MR成像。在腹侧、中间和背侧区域选择相应的感兴趣区,测量并比较¹H信号变化和³He信号。
在所有志愿者和患者中,肺总量(TLC)与残气量(RV)之间的质子信号差异与³He信号呈正相关(相关系数R² = 0.64,P <.001)。功能残气量(FRC)与高于FRC 1 L处(FRC + 1 L)之间的¹H信号差异也呈较低(P <.001)但为正的相关结果(R² = 0.44,P <.001)。与阻塞性疾病患者相比,健康志愿者的¹H信号变化显示出更高的中位数和四分位间距,且非依赖区和依赖区之间存在显著差异。
本研究结果表明,无需使用对比剂的多容积¹H MR成像可作为健康志愿者和阻塞性肺疾病患者区域通气的生物标志物。