Kołodziej Magdalena, de Veer Michael J, Cholewa Marian, Egan Gary F, Thompson Bruce R
Monash Biomedical Imaging, Monash University, Melbourne, 3800, Australia.
Institute of Nursing and Health Sciences, Medical Faculty, University of Rzeszow, 35-959, Rzeszow, Poland.
Respir Res. 2017 May 17;18(1):96. doi: 10.1186/s12931-017-0578-x.
Monitoring of pulmonary physiology is fundamental to the clinical management of patients with Cystic Fibrosis. The current standard clinical practise uses spirometry to assess lung function which delivers a clinically relevant functional readout of total lung function, however does not supply any visible or localised information. High Resolution Computed Tomography (HRCT) is a well-established current 'gold standard' method for monitoring lung anatomical changes in Cystic Fibrosis patients. HRCT provides excellent morphological information, however, the X-ray radiation dose can become significant if multiple scans are required to monitor chronic diseases such as cystic fibrosis. X-ray phase-contrast imaging is another emerging X-ray based methodology for Cystic Fibrosis lung assessment which provides dynamic morphological and functional information, albeit with even higher X-ray doses than HRCT. Magnetic Resonance Imaging (MRI) is a non-ionising radiation imaging method that is garnering growing interest among researchers and clinicians working with Cystic Fibrosis patients. Recent advances in MRI have opened up the possibilities to observe lung function in real time to potentially allow sensitive and accurate assessment of disease progression. The use of hyperpolarized gas or non-contrast enhanced MRI can be tailored to clinical needs. While MRI offers significant promise it still suffers from poor spatial resolution and the development of an objective scoring system especially for ventilation assessment.
监测肺部生理学对囊性纤维化患者的临床管理至关重要。目前的标准临床实践使用肺活量测定法来评估肺功能，该方法可提供与临床相关的全肺功能功能性读数，但无法提供任何可见或局部信息。高分辨率计算机断层扫描（HRCT）是目前用于监测囊性纤维化患者肺部解剖结构变化的公认“金标准”方法。HRCT可提供出色的形态学信息，然而，如果需要多次扫描来监测诸如囊性纤维化等慢性疾病，X射线辐射剂量可能会变得很大。X射线相衬成像技术是另一种新兴的基于X射线的囊性纤维化肺部评估方法，它能提供动态的形态学和功能信息，尽管其X射线剂量比HRCT更高。磁共振成像（MRI）是一种非电离辐射成像方法，正引起研究囊性纤维化患者的研究人员和临床医生越来越浓厚的兴趣。MRI的最新进展为实时观察肺功能开辟了可能性，从而有可能对疾病进展进行敏感而准确的评估。超极化气体或非对比增强MRI的使用可根据临床需求进行调整。虽然MRI前景广阔，但它仍然存在空间分辨率差的问题，并且缺乏一个客观的评分系统，尤其是在通气评估方面。
