自由呼吸动态 F 气体 MR 成像在 COPD 患者区域性肺通气中的应用。
Free-breathing Dynamic F Gas MR Imaging for Mapping of Regional Lung Ventilation in Patients with COPD.
机构信息
From the Institute for Diagnostic and Interventional Radiology (M.G., T.F.K., A.V., F.W., J.V.C.), Institute of Biometry (F.L.), and Clinic of Pneumology (J.F., T.W., J.M.H.), Hannover Medical School, Carl-Neuberg Str 1, 30625 Hannover, Germany; Biomedical Research in Endstage and Obstructive Lung Disease Hannover, the German Center for Lung Research, Hannover, Germany (M.G., T.F.K., A.V., J.F., T.W., F.W., J.M.H., J.V.C.); and Fraunhofer Institute for Toxicology and Experimental Medicine, Clinical Airway Research, Hannover, Germany (J.M.H.).
出版信息
Radiology. 2018 Mar;286(3):1040-1051. doi: 10.1148/radiol.2017170591. Epub 2017 Oct 3.
Purpose To quantify regional lung ventilation in patients with chronic obstructive pulmonary disease (COPD) by using free-breathing dynamic fluorinated (fluorine 19 [F]) gas magnetic resonance (MR) imaging. Materials and Methods In this institutional review board-approved prospective study, 27 patients with COPD were examined by using breath-hold F gas wash-in MR imaging during inhalation of a normoxic fluorinated gas mixture (perfluoropropane) and by using free-breathing dynamic F gas washout MR imaging after inhalation of the gas mixture was finished for a total of 25-30 L. Regional lung ventilation was quantified by using volume defect percentage (VDP), washout time, number of breaths, and fractional ventilation (FV). To compare different lung function parameters, Pearson correlation coefficient and Fisher z transformation were used, which were corrected for multiple comparisons with the Bonferroni method. Results Statistically significant correlations were observed for all evaluated lung function test parameters compared with median and interquartile range of F washout parameters. An inverse linear correlation of median number of breaths (r = -0.82; P < .0001) and median washout times (r = -0.77; P < .0001) with percentage predicted of forced expiratory volume in 1 second (FEV) was observed; correspondingly median FV (r = 0.86; P < .0001) correlated positively with percentage predicted FEV. Comparing initial with late phase, median VDP of all subjects decreased from 49% (25th-75th percentile, 35%-62%) to 6% (25th-75th percentile, 2%-10%; P < .0001). VDP at the beginning of the gas wash-in phase (VDP) significantly correlated with percentage predicted FEV (r = -0.74; P = .0028) and FV (r = 0.74; P = .0002). Median FV was significantly increased in ventilated regions (11.1% [25th-75th percentile, 6.8%-14.5%]) compared with the defect regions identified by VDP (5.8% [25th-75th percentile, 4.0%-7.4%]; P < .0001). Conclusion Quantification of regional lung ventilation by using dynamic F gas washout MR imaging in free breathing is feasible at 1.5 T even in obstructed lung segments. RSNA, 2017 Online supplemental material is available for this article.
目的 利用自由呼吸动态氟气（氟 19[F]）磁共振成像定量检测慢性阻塞性肺疾病（COPD）患者的区域性肺通气。
材料与方法 在这项经机构审查委员会批准的前瞻性研究中，27 例 COPD 患者通过吸入含氧氟气混合物（全氟丙烷）时的屏气氟气气体吸入 MR 成像和吸入气体混合物后进行自由呼吸动态氟气清除 MR 成像来检测区域性肺通气，共进行 25-30 L。通过容积缺陷百分比（VDP）、清除时间、呼吸次数和分数通气（FV）定量检测区域性肺通气。为了比较不同的肺功能参数，使用 Pearson 相关系数和 Fisher z 变换，并采用 Bonferroni 方法进行了多次比较校正。
结果 与中位数和四分位数范围的 F 清除参数相比，所有评估的肺功能测试参数均与所有评价的肺功能测试参数具有显著相关性。中位呼吸次数（r = -0.82；P <.0001）和中位清除时间（r = -0.77；P <.0001）与 1 秒用力呼气量（FEV）预计百分比呈负相关；相应地，中位 FV（r = 0.86；P <.0001）与 FEV 预计百分比呈正相关。与初始期相比，所有患者的中位 VDP 从 49%（25%至 75%，35%至 62%）降至 6%（25%至 75%，2%至 10%；P <.0001）。气体冲洗期开始时的 VDP（VDP）与 FEV 预计百分比（r = -0.74；P =.0028）和 FV（r = 0.74；P =.0002）呈显著负相关。与 VDP 确定的缺陷区域相比，通气区域的中位 FV（11.1%[25%至 75%，6.8%至 14.5%]）显著增加（P <.0001）。
结论 在 1.5 T 场强下，即使在阻塞性肺段，自由呼吸状态下利用动态 F 气体清除 MR 成像进行区域性肺通气定量检测也是可行的。
RSNA，2017 年。
在线补充材料，本文提供。
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