Donnola Shannon B, Dasenbrook Elliott C, Weaver David, Lu Lan, Gupta Karishma, Prabhakaran Anjali, Yu Xin, Chmiel James F, McBennett Kimberly, Konstan Michael W, Drumm Mitchell L, Flask Chris A
Department of Radiology, Case Western Reserve University, Cleveland, OH, USA.
Department of Pediatrics, Case Western Reserve University, Cleveland, OH, USA; Department of Medicine, Case Western Reserve University, Cleveland, OH, USA; Rainbow Babies and Children's Hospital, Cleveland, OH, USA.
J Cyst Fibros. 2017 Mar;16(2):283-290. doi: 10.1016/j.jcf.2015.11.009. Epub 2015 Dec 22.
Previous studies have shown that Magnetic Resonance Imaging (MRI) techniques can be used to non-invasively assess lung disease in CF patients. In this study, we compare the sensitivity of normalized T1 (nT1) and non-contrast perfusion MRI techniques to detect regional lung disease in CF patients.
MRI data were obtained for eight adult CF patients without overt pulmonary exacerbation (FEV1=45-127%) and six healthy volunteers on a Siemens Espree 1.5T MRI scanner. Sagittal nT1 and perfusion data were acquired for each subject's left and right lungs. A region-of-interest analysis was used to calculate mean nT1 and perfusion values in the individual lobes of the left and right lungs for each subject.
In comparison to healthy controls, CF subjects showed a significant decrease in nT1 values in the upper lobe of the left lung as well as in the upper and anterior lobes of the right lung (p<0.001). Similar nT1 differences were observed with in the CF cohort in comparison to their respective posterior lobes (p<0.001). Pulmonary perfusion for the CF subjects was also significantly reduced in the upper lobe of the right lung (p<0.05). Significant correlations with spirometry were also observed for both nT1 (left upper lobe: p<0.01) and perfusion (left and right upper lobes (p≤0.05)). Additionally, significant correlations were observed between nT1 and perfusion in the upper lobes of the left (p=0.05) and right lungs (p=0.005).
This pilot study confirms that both the nT1 and non-contrast perfusion MRI techniques can sensitively detect regional lung changes in patients with CF. While both imaging methods were able to detect regional lung disease, the additional nT1 reductions in the CF patients suggests that nT1 may be more sensitive to regional CF lung disease.
先前的研究表明，磁共振成像（MRI）技术可用于无创评估囊性纤维化（CF）患者的肺部疾病。在本研究中，我们比较了标准化T1（nT1）和非增强灌注MRI技术检测CF患者局部肺部疾病的敏感性。
在西门子Espree 1.5T MRI扫描仪上，对8名无明显肺部加重（第1秒用力呼气容积[FEV1]=45%-127%）的成年CF患者和6名健康志愿者进行了MRI数据采集。获取了每个受试者左、右肺的矢状面nT1和灌注数据。采用感兴趣区分析计算每个受试者左、右肺各叶的平均nT1和灌注值。
与健康对照相比，CF受试者左肺上叶以及右肺上叶和前叶的nT1值显著降低（p<0.001）。在CF队列中，与各自的后叶相比也观察到类似的nT1差异（p<0.001）。CF受试者右肺上叶的肺灌注也显著降低（p<0.05）。nT1（左上叶：p<0.01）和灌注（左、右上叶（p≤0.05））与肺功能测定也存在显著相关性。此外，在左肺（p=0.05）和右肺（p=0.005）的上叶中，nT1与灌注之间也存在显著相关性。
这项初步研究证实，nT1和非增强灌注MRI技术均可灵敏检测CF患者的局部肺部变化。虽然两种成像方法都能够检测局部肺部疾病，但CF患者额外的nT1降低表明nT1可能对局部CF肺部疾病更敏感。
