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慢性阻塞性肺疾病(COPD)和哮喘患者中氧增强T1定量的可重复性及比较

Reproducibility and comparison of oxygen-enhanced T1 quantification in COPD and asthma patients.

作者信息

Triphan Simon M F, Jobst Bertram J, Anjorin Angela, Sedlaczek Oliver, Wolf Ursula, Terekhov Maxim, Hoffmann Christian, Ley Sebastian, Düber Christoph, Biederer Jürgen, Kauczor Hans-Ulrich, Jakob Peter M, Wielpütz Mark O

机构信息

Department of Diagnostic & Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.

Translational Lung Research Center Heidelberg (TLRC), Member of the German Lung Research Center (DZL), Heidelberg, Germany.

出版信息

PLoS One. 2017 Feb 16;12(2):e0172479. doi: 10.1371/journal.pone.0172479. eCollection 2017.

Abstract

T1 maps have been shown to yield useful diagnostic information on lung function in patients with chronic obstructive pulmonary disease (COPD) and asthma, both for native T1 and ΔT1, the relative reduction while breathing pure oxygen. As parameter quantification is particularly interesting for longitudinal studies, the purpose of this work was both to examine the reproducibility of lung T1 mapping and to compare T1 found in COPD and asthma patients using IRSnapShotFLASH embedded in a full MRI protocol. 12 asthma and 12 COPD patients (site 1) and further 15 COPD patients (site 2) were examined on two consecutive days. In each patient, T1 maps were acquired in 8 single breath-hold slices, breathing first room air, then pure oxygen. Maps were partitioned into 12 regions each to calculate average values. In asthma patients, the average T1,RA = 1206ms (room air) was reduced to T1,O2 = 1141ms under oxygen conditions (ΔT1 = 5.3%, p < 5⋅10-4), while in COPD patients both native T1,RA = 1125ms was significantly shorter (p < 10-3) and the relative reduction to T1,O2 = 1081ms on average ΔT1 = 4.2%(p < 10-5). On the second day, with T1,RA = 1186ms in asthma and T1,RA = 1097ms in COPD, observed values were slightly shorter on average in all patient groups. ΔT1 reduction was the least repeatable parameter and varied from day to day by up to 23% in individual asthma and 30% in COPD patients. While for both patient groups T1 was below the values reported for healthy subjects, the T1 and ΔT1 found in asthmatics lies between that of the COPD group and reported values for healthy subjects, suggesting a higher blood volume fraction and better ventilation. However, it could be demonstrated that lung T1 quantification is subject to notable inter-examination variability, which here can be attributed both to remaining contrast agent from the previous day and the increased dependency of lung T1 on perfusion and thus current lung state.

摘要

T1 图谱已被证明能为慢性阻塞性肺疾病(COPD)和哮喘患者的肺功能提供有用的诊断信息,无论是对于原生 T1 还是 ΔT1(呼吸纯氧时的相对降低值)。由于参数定量对于纵向研究特别有意义,这项工作的目的是检验肺 T1 图谱的可重复性,并使用完整 MRI 协议中嵌入的 IRSnapShotFLASH 比较 COPD 和哮喘患者的 T1 值。12 名哮喘患者和 12 名 COPD 患者(站点 1)以及另外 15 名 COPD 患者(站点 2)在连续两天接受检查。在每位患者中,在 8 个单次屏气切片中采集 T1 图谱,先呼吸室内空气,然后呼吸纯氧。图谱被划分为 12 个区域,分别计算平均值。在哮喘患者中,平均 T1,RA = 1206ms(室内空气)在吸氧条件下降低至 T1,O2 = 1141ms(ΔT1 = 5.3%,p < 5×10⁻⁴),而在 COPD 患者中,原生 T1,RA = 1125ms 显著更短(p < 10⁻³),平均相对降低至 T1,O2 = 1081ms,ΔT1 = 4.2%(p < 10⁻⁵)。在第二天,哮喘患者的 T1,RA = 1186ms,COPD 患者的 T1,RA = 1097ms,所有患者组的观测值平均略短。ΔT1 降低是最不可重复的参数,在个体哮喘患者中每天变化高达 23%,在 COPD 患者中高达 30%。虽然两个患者组的 T1 均低于健康受试者报告的值,但哮喘患者的 T1 和 ΔT1 值介于 COPD 组和健康受试者报告值之间,表明血容量分数更高且通气更好。然而,可以证明肺 T1 定量存在显著的检查间变异性,这里这既可以归因于前一天残留的造影剂,也归因于肺 T1 对灌注以及因此对当前肺状态的依赖性增加。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/306c/5312969/fb4e62dc4623/pone.0172479.g001.jpg

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