Konietzke Philip, Weinheimer Oliver, Triphan Simon M F, Nauck Sebastian, Wuennemann Felix, Konietzke Marilisa, Jobst Bertram J, Jörres Rudolf A, Vogelmeier Claus F, Heussel Claus P, Kauczor Hans-Ulrich, Wielpütz Mark O, Biederer Jürgen
Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.
Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), University of Heidelberg, Heidelberg, Germany.
Eur Radiol. 2025 Jan 8. doi: 10.1007/s00330-024-11269-3.
We hypothesized that semiquantitative visual scoring of lung MRI is suitable for GOLD-grade specific characterization of parenchymal and airway disease in COPD and that MRI scores correlate with quantitative CT (QCT) and pulmonary function test (PFT) parameters.
Five hundred ninety-eight subjects from the COSYCONET study (median age = 67 (60-72)) at risk for COPD or with GOLD1-4 underwent PFT, same-day paired inspiratory/expiratory CT, and structural and contrast-enhanced MRI. QCT assessed total lung volume (TLV), emphysema, and air trapping by parametric response mapping (PRM, PRM) and airway disease by wall percentage (WP). MRI was analyzed using a semiquantitative visual scoring system for parenchymal defects, perfusion defects, and airway abnormalities. Descriptive statistics, Spearman correlations, and ANOVA analyses were performed.
TLV, PRM, and MRI scores for parenchymal and perfusion defects were all higher with each GOLD grade, reflecting the extension of emphysema (all p < 0.001). Airway analysis showed the same trends with higher WP and higher MRI large airway disease scores in GOLD3 and lower WP and MRI scores in GOLD4 (p = 0.236 and p < 0.001). Regional heterogeneity was less evident on MRI, while PRM and MRI perfusion defect scores were higher in the upper lobes, and WP and MRI large airway disease scores were higher in the lower lobes. MRI parenchymal and perfusion scores correlated moderately with PRM (r = 0.61 and r = 0.60) and moderately with FEV1/FVC (r = -0.56).
Multi-center semiquantitative MRI assessments of parenchymal and airway disease in COPD matched GOLD grade-specific imaging features on QCT and detected regional disease heterogeneity. MRI parenchymal disease scores were correlated with QCT and lung function parameters.
Question Do MRI-based scores correlate with QCT and PFT parameters for GOLD-grade specific disease characterization of COPD? Findings MRI can visualize the parenchymal and airway disease features of COPD. Clinical relevance Lung MRI is suitable for GOLD-grade specific disease characterization of COPD and may serve as a radiation-free imaging modality in scientific and clinical settings, given careful consideration of its potential and limitations.
我们假设肺部MRI的半定量视觉评分适用于慢性阻塞性肺疾病（COPD）中实质性和气道疾病的GOLD分级特异性特征描述，且MRI评分与定量CT（QCT）和肺功能测试（PFT）参数相关。
来自COSYCONET研究的598名受试者（中位年龄=67（60 - 72）岁），有COPD风险或患有GOLD1 - 4级疾病，接受了PFT、同日配对吸气/呼气CT以及结构和对比增强MRI检查。QCT通过参数反应映射（PRM）评估总肺容量（TLV）、肺气肿和气体潴留，并通过壁百分比（WP）评估气道疾病。使用半定量视觉评分系统分析MRI的实质性缺陷、灌注缺陷和气道异常。进行了描述性统计、Spearman相关性分析和方差分析。
随着GOLD分级的增加，实质性和灌注缺陷的TLV、PRM和MRI评分均升高，反映了肺气肿的扩展（所有p<0.001）。气道分析显示了相同的趋势，GOLD3级的WP和MRI大气道疾病评分较高，GOLD4级的WP和MRI评分较低（p = 0.236和p<0.001）。MRI上区域异质性不太明显，而PRM和MRI灌注缺陷评分在上叶较高，WP和MRI大气道疾病评分在下叶较高。MRI实质性和灌注评分与PRM中度相关（r = 0.61和r = 0.60），与FEV1/FVC中度相关（r = -0.56）。
对COPD的实质性和气道疾病进行多中心半定量MRI评估，与QCT上的GOLD分级特异性成像特征相匹配，并检测到区域疾病异质性。MRI实质性疾病评分与QCT和肺功能参数相关。
问题基于MRI的评分与用于COPD的GOLD分级特异性疾病特征描述的QCT和PFT参数相关吗？发现MRI可以可视化COPD的实质性和气道疾病特征。临床意义肺部MRI适用于COPD的GOLD分级特异性疾病特征描述，并且在科学和临床环境中，鉴于仔细考虑其潜力和局限性，可作为无辐射成像方式。
