Center for Pulmonary Imaging Research, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, U.S.A.
Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, U.S.A.
Laryngoscope. 2021 Jun;131(6):E1971-E1979. doi: 10.1002/lary.29363. Epub 2021 Jan 5.
OBJECTIVE/HYPOTHESIS: To assess the ability of ultra-short echo time (UTE)-MRI to detect subglottic stenosis (SGS) and evaluate response to balloon dilation. To correlate measurements from UTE-MRI with endotracheal-tube (ETT)-sizing and to investigate whether SGS causes change in airway dynamics.
Animal research study.
Eight adult New-Zealand white rabbits were used as they approximate neonatal airway-size. The airways were measured using ETT-sizing and 3D UTE-MRI at baseline, 2 weeks post-cauterization induced SGS injury, and post-balloon dilation treatment. UTE-MR images were acquired to determine airway anatomy and motion. Airways were segmented from MR images. Cross-sectional area (CSA), major and minor diameters (D and D ), and eccentricity were measured.
Post-injury CSA at SGS was significantly reduced (mean 38%) compared to baseline (P = .003) using UTE-MRI. ETT-sizing correlated significantly with MRI-measured CSA at the SGS location (r = 0.6; P < .01), particularly at the post-injury timepoint (r = 0.93; P < .01). Outer diameter from ETT-sizing (OD) correlated significantly with D (r = 0.63; P < .01) from UTE-MRI at the SGS location, especially for the post-injury timepoint (r = 0.91; P < .01). Mean CSA of upper trachea did not change significantly between end-expiration and end-inspiration at any timepoint (all P > .05). Eccentricity of the upper trachea increased significantly post-balloon dilation (P < .05).
UTE-MRI successfully detected SGS and treatment response in the rabbit model, with good correlation to ETT-sizing. Balloon dilation increased CSA at SGS, but not to baseline values. SGS did not alter dynamic motion for the trachea in this rabbit model; however, tracheas were significantly eccentric post-balloon dilation. UTE-MRI can detect SGS without sedation or ionizing radiation and may be a non-invasive alternative to ETT-sizing.
NA Laryngoscope, 131:E1971-E1979, 2021.
目的/假设：评估超短回波时间（UTE）-MRI 检测声门下狭窄（SGS）和评估球囊扩张反应的能力。将 UTE-MRI 测量值与气管内管（ETT）尺寸相关联，并研究 SGS 是否导致气道动力学变化。
动物研究。
使用 8 只成年新西兰白兔，因为它们近似于新生儿气道大小。在基线、SGS 损伤后 2 周和球囊扩张治疗后，使用 ETT 尺寸和 3D UTE-MRI 测量气道。采集 UTE-MR 图像以确定气道解剖结构和运动。从 MR 图像中分割气道。测量横截面积（CSA）、主直径（D）和次直径（D）以及偏心率。
使用 UTE-MRI，SGS 损伤后 CSA 明显减少（平均减少 38%）（P =.003）。ETT 尺寸与 SGS 位置的 MRI 测量 CSA 显著相关（r = 0.6；P < .01），尤其是在损伤后时间点（r = 0.93；P < .01）。ETT 尺寸的外径（OD）与 SGS 位置的 UTE-MRI 的 D （r = 0.63；P < .01）显著相关，尤其是在损伤后时间点（r = 0.91；P < .01）。在任何时间点，呼气末和吸气末之间的上气管的平均 CSA 均无明显变化（均 P > .05）。球囊扩张后 SGS 的偏心度显著增加（P < .05）。
UTE-MRI 成功地在兔模型中检测到 SGS 和治疗反应，与 ETT 尺寸具有良好的相关性。球囊扩张增加了 SGS 的 CSA，但未达到基线值。在这个兔模型中，SGS 并没有改变气管的动态运动；然而，球囊扩张后气管明显偏心。UTE-MRI 可以在没有镇静或电离辐射的情况下检测到 SGS，并且可能是 ETT 尺寸的替代方法。
无喉镜，131：E1971-E1979，2021。
