相位对比磁共振成像用于检测哮喘患者节段性变应原激发后轻微的全身血流动力学反应。

Phase-contrast MRI for detection of mild systemic hemodynamic response after segmental allergen challenge in asthmatic patients.

作者信息

Hinrichs Jan, Schaumann Frank, Renne Julius, Schönfeld Christian, Faulenbach Cornelia, Winkler Christina, Gutberlet Marcel, Krug Norbert, Wacker Frank, Hohlfeld Jens M, Vogel-Claussen Jens

机构信息

Institute of Interventional Radiology, Hannover Medical School, Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research, OE 8220, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.

Fraunhofer Institute for Toxicology and Experimental Medicine, Hannover Medical School, Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research, Hannover, Germany.

出版信息

Acad Radiol. 2014 Aug;21(8):994-1001. doi: 10.1016/j.acra.2014.03.003.

DOI:10.1016/j.acra.2014.03.003

PMID:25018071

Abstract

RATIONALE AND OBJECTIVES

Detection of a systemic hemodynamic response in patients suffering from allergic asthma after segmental endobronchial allergen challenge using phase-contrast magnetic resonance imaging (MRI).

MATERIALS AND METHODS

Nine asthma patients and four healthy volunteers were examined using MRI (1.5T) before (0 hour), 6 hours, and 24 hours after segmental allergen challenge. Two-dimensional phase-contrast MRI measurements were performed in the aorta (AO) and in the pulmonary artery (PA). In addition, short-axis balanced steady state free precession cardiac cine MRI was performed. Maximum systolic flow, maximum flow acceleration, acceleration volume, acceleration time, distensibility, ejection fraction, stroke volume, end-systolic/diastolic volume, cardiac mass, heart rate (HR), and cardiac output (CO) were determined. Spirometry and bronchoalveolar lavage were also performed.

RESULTS

In patients with asthma, maximal systolic flow and maximal flow acceleration increased 6 hours after provocation in the AO (112.3% and 118.9%, respectively) and PA (113.9% and 116.0%, respectively) compared to baseline (100%, P < .05). HR and CO increased significantly at 6 hours (115% and 118%, respectively) compared to baseline (100%, P = .003). In healthy subjects, almost all MRI-derived hemodynamic parameters did not significantly change at 6 hours and were significantly lower than baseline values at 24 hours (P < .02). Twenty-four hours after allergen challenge, all MRI-derived flow parameters were significantly lower in the control group compared to the asthma group (P < .05). HR, CO, and cardiac function parameters measured at 24 hours showed no significant difference comparing the two groups (P > .05).

CONCLUSIONS

In asthmatic patients, MRI-derived hemodynamic parameters using phase-contrast MRI are slightly altered after segmental allergen provocation compared to normal controls indicating a mild systemic reaction to local allergen challenge.

摘要

原理与目的

使用相位对比磁共振成像（MRI）检测节段性支气管内过敏原激发后过敏性哮喘患者的全身血流动力学反应。

材料与方法

对9名哮喘患者和4名健康志愿者在节段性过敏原激发前（0小时）、激发后6小时和24小时进行MRI（1.5T）检查。在主动脉（AO）和肺动脉（PA）中进行二维相位对比MRI测量。此外，还进行了短轴平衡稳态自由进动心脏电影MRI检查。测定最大收缩期血流、最大血流加速度、加速容积、加速时间、扩张性、射血分数、每搏输出量、收缩末期/舒张末期容积、心脏质量、心率（HR）和心输出量（CO）。还进行了肺功能测定和支气管肺泡灌洗。

结果

与基线相比（100%），哮喘患者在激发后6小时，AO的最大收缩期血流和最大血流加速度分别增加了112.3%和118.9%，PA的分别增加了113.9%和116.0%（P <.05）。与基线相比（100%），HR和CO在6小时时显著增加（分别为115%和118%，P =.003）。在健康受试者中，几乎所有MRI衍生的血流动力学参数在6小时时无显著变化，且在24小时时显著低于基线值（P <.02）。过敏原激发后24小时，对照组所有MRI衍生的血流参数均显著低于哮喘组（P <.05）。两组在24小时时测量的HR、CO和心脏功能参数无显著差异（P >.05）。