Wielpütz Mark O, Mall Marcus A
aDepartment of Diagnostic and Interventional Radiology, University Hospital Heidelberg bDepartment of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik at University Hospital Heidelberg cTranslational Lung Research Center Heidelberg (TLRC), Member of the German Center for Lung Research (DZL), University of Heidelberg dDivision of Pediatric Pulmonology and Allergy and Cystic Fibrosis Center, Department of Pediatrics, University Hospital Heidelberg eDepartment of Translational Pulmonology, University Hospital Heidelberg, Heidelberg, Germany.
Curr Opin Pulm Med. 2015 Nov;21(6):609-16. doi: 10.1097/MCP.0000000000000213.
MRI has emerged as radiation-free imaging modality for assessment of cystic fibrosis lung disease. Here, we review the current status and new developments of MRI in cystic fibrosis.
MRI is sensitive to detect abnormalities in lung structure and perfusion, even in preschool children with cystic fibrosis with early lung disease. Further, MRI is sensitive to detect changes associated with pulmonary exacerbations and response to antibiotic therapy in this challenging age group.
MRI is sensitive to detect hallmarks of cystic fibrosis lung disease such as bronchial wall thickening, bronchiectasis, mucus plugging and abnormal lung perfusion. A morpho-functional MRI score has been established for semiquantitative assessment of these characteristic abnormalities over a broad range of disease severity. Recent studies demonstrated that MRI is sensitive to detect changes in mucus plugging and lung perfusion in response to antibiotic therapy for pulmonary exacerbations. These results suggest that MRI may be suitable for noninvasive monitoring and as a quantitative endpoint in clinical trials for cystic fibrosis. Technical advances including ultra-short echo time and Fourier decomposition imaging are expected to enhance morphological and functional MRI of cystic fibrosis lung disease without the need of contrast medium in the near future.
磁共振成像(MRI)已成为用于评估囊性纤维化肺病的无辐射成像方式。在此,我们综述MRI在囊性纤维化方面的现状和新进展。
MRI对检测肺结构和灌注异常很敏感,即使是患有早期肺病的学龄前囊性纤维化儿童。此外,在这个具有挑战性的年龄组中,MRI对检测与肺部加重相关的变化以及对抗生素治疗的反应也很敏感。
MRI对检测囊性纤维化肺病的特征很敏感,如支气管壁增厚、支气管扩张、黏液嵌塞和异常的肺灌注。已经建立了一种形态功能MRI评分系统,用于在广泛的疾病严重程度范围内对这些特征性异常进行半定量评估。最近的研究表明,MRI对检测肺部加重期抗生素治疗后黏液嵌塞和肺灌注的变化很敏感。这些结果表明,MRI可能适用于无创监测,并作为囊性纤维化临床试验中的定量终点。包括超短回波时间和傅里叶分解成像在内的技术进步有望在不久的将来无需使用造影剂就能增强囊性纤维化肺病的形态学和功能MRI。