Computer Assisted Clinical Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Mannheim Institute for Intelligent Systems in Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Eur Radiol. 2024 Jun;34(6):3761-3772. doi: 10.1007/s00330-023-10335-6. Epub 2023 Nov 8.
To investigate the feasibility of non-contrast-enhanced functional lung imaging in 2-year-old children after congenital diaphragmatic hernia (CDH) repair.
Fifteen patients after CDH repair were examined using non-contrast-enhanced dynamic magnetic resonance imaging (MRI). For imaging two protocols were used during free-breathing: Protocol A with high temporal resolution and Protocol B with high spatial resolution. The dynamic images were then analysed through a recently developed post-processing method called dynamic mode decomposition (DMD) to obtain ventilation and perfusion maps. The ventilation ratios (V) and perfusion ratios (Q) of ipsilateral to contralateral lung were compared to evaluate functional differences. Lastly, DMD MRI-based perfusion results were compared with perfusion parameters obtained using dynamic contrast-enhanced (DCE) MRI to assess agreement between methods.
Both imaging protocols successfully generated pulmonary ventilation (V) and perfusion (Q) maps in all patients. Overall, the V and Q values were 0.84 ± 0.19 and 0.70 ± 0.24 for Protocol A, and 0.88 ± 0.18 and 0.72 ± 0.23 for Protocol B, indicating reduced ventilation ( ) and perfusion ( ) on the ipsilateral side. Moreover, there is a very strong positive correlation ( ) and close agreement between DMD MRI-based perfusion values and DCE MRI-based perfusion parameters.
DMD MRI can obtain pulmonary functional information in 2-year-old CDH patients. The results obtained with DMD MRI correlate with DCE MRI, without the need for ionising radiation or exposure to contrast agents. While further studies with larger cohorts are warranted, DMD MRI is a promising option for functional lung imaging in CDH patients.
We demonstrate that pulmonary ventilation and perfusion information can be obtained in 2-year-old patients after CDH repair, without the need for ionising radiation or contrast agents by utilising non-contrast-enhanced MRI acquisitions together with dynamic mode decomposition analysis.
• Non-contrast-enhanced functional MR imaging is a promising option for functional lung imaging in 2-year-old children after congenital diaphragmatic hernia. • DMD MRI can generate pulmonary ventilation and perfusion maps from free-breathing dynamic acquisitions without the need for ionising radiation or contrast agents. • Lung perfusion parameters obtained with DMD MRI correlate with perfusion parameters obtained using dynamic contrast-enhanced MRI.
研究非对比增强功能肺成像在先天性膈疝（CDH）修复后 2 岁儿童中的可行性。
15 例 CDH 修复后患者采用非对比增强动态磁共振成像（MRI）检查。对于成像，使用两种自由呼吸协议：协议 A 具有高时间分辨率，协议 B 具有高空间分辨率。然后通过最近开发的称为动态模式分解（DMD）的后处理方法分析动态图像，以获得通气和灌注图。比较同侧和对侧肺的通气比（V）和灌注比（Q），以评估功能差异。最后，将 DMD MRI 基于灌注的结果与使用动态对比增强（DCE）MRI 获得的灌注参数进行比较，以评估两种方法之间的一致性。
两种成像方案均成功地为所有患者生成了肺通气（V）和灌注（Q）图。总体而言，协议 A 的 V 和 Q 值分别为 0.84±0.19 和 0.70±0.24，协议 B 的 V 和 Q 值分别为 0.88±0.18 和 0.72±0.23，表明同侧通气（ ）和灌注（ ）减少。此外，DMD MRI 基于灌注值与 DCE MRI 基于灌注参数之间存在非常强的正相关（ ）和紧密一致。
DMD MRI 可在 2 岁 CDH 患者中获得肺功能信息。DMD MRI 获得的结果与 DCE MRI 相关，无需电离辐射或造影剂。虽然需要进一步的大样本队列研究，但 DMD MRI 是 CDH 患者功能性肺成像的一种很有前途的选择。
我们证明，通过利用非对比增强 MRI 采集和动态模式分解分析，无需电离辐射或造影剂，即可在 CDH 修复后 2 岁的患者中获得肺通气和灌注信息。
• 非对比增强功能磁共振成像对于先天性膈疝修复后 2 岁儿童的功能性肺成像具有很大的应用前景。
• DMD MRI 可从自由呼吸动态采集生成肺通气和灌注图，无需电离辐射或造影剂。
• DMD MRI 获得的肺灌注参数与使用动态对比增强 MRI 获得的灌注参数相关。
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