Xu Jian, Wang Lu, Tong Lin, Li Huiting, Wu Xu, Wang Yuhan, Li Li, Gong Ying, Bi Jing, Tao Jiale, Zhang Ke, Li Maokun, Duan Hongyu, Guan Mingtao, Liang Haiqing, Wang Yibing, Song Yuanlin
Shanghai Key Laboratory of Lung Inflammation and Injury, Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.
Shanghai Respiratory Research Institute, Shanghai, China.
J Thorac Dis. 2025 Jul 31;17(7):4837-4848. doi: 10.21037/jtd-2025-275. Epub 2025 Jul 29.
Non-invasive bedside detection of pulmonary ventilation and perfusion remains a challenge. Electrical impedance tomography (EIT) uses a differential imaging technique to reconstruct images of lung ventilation and perfusion. Conventional methods of perfusion signal acquisition are achieved by breath-holding and hypertonic saline injection, limiting its widespread application. This study aimed to develop a novel EIT methodology for acquiring comprehensive pulmonary ventilation-perfusion images and to validate the reliability of this non-invasive perfusion signal acquisition method across a series of clinical cases.
A novel three-dimensional EIT (3D-EIT) method for whole-lung ventilation and perfusion imaging was developed. The perfusion signals were acquired by a pulsatility signal-based algorithm. Complete ventilation and perfusion images were reconstructed in healthy subjects and 3D-EIT perfusion imaging was assessed for perfusion defects in patients with pulmonary bullae, undergoing Swan-Ganz catheterization, or with acute pulmonary embolism.
Novel 3D-EIT successfully reconstructed whole-lung ventilation and perfusion images. In patients with pulmonary bullae, EIT perfusion signals at the bullae site were deficient. In patients receiving Swan-Ganz catheterization, the perfusion signals of the corresponding lung segments were reduced when the balloon was wedged and restored when the balloon was released. 3D-EIT also detected significant recovery of perfusion signal at the region of embolism after treatments in patients with pulmonary embolism.
3D-EIT enables non-invasive monitoring of whole-lung ventilation and perfusion. The fidelity of perfusion images has been demonstrated in several different cases. Novel EIT technology provides many new potential possibilities for the diagnosis and therapeutic evaluation of lung ventilation and perfusion problems.
肺部通气和灌注的无创床边检测仍然是一项挑战。电阻抗断层成像（EIT）使用差分成像技术来重建肺通气和灌注图像。传统的灌注信号采集方法是通过屏气和注射高渗盐水来实现的，这限制了其广泛应用。本研究旨在开发一种新的EIT方法，用于获取全面的肺通气-灌注图像，并在一系列临床病例中验证这种无创灌注信号采集方法的可靠性。
开发了一种用于全肺通气和灌注成像的新型三维EIT（3D-EIT）方法。通过基于搏动性信号的算法采集灌注信号。在健康受试者中重建完整的通气和灌注图像，并对患有肺大疱、正在接受 Swan-Ganz 导管插入术或患有急性肺栓塞的患者进行 3D-EIT 灌注成像，以评估灌注缺陷。
新型 3D-EIT 成功重建了全肺通气和灌注图像。在患有肺大疱的患者中，大疱部位的 EIT 灌注信号不足。在接受 Swan-Ganz 导管插入术的患者中，当球囊楔入时，相应肺段的灌注信号降低，当球囊释放时恢复。3D-EIT 还检测到肺栓塞患者治疗后栓塞区域的灌注信号有显著恢复。
3D-EIT 能够对全肺通气和灌注进行无创监测。在几种不同的病例中已证明灌注图像的保真度。新型 EIT 技术为肺通气和灌注问题的诊断和治疗评估提供了许多新的潜在可能性。
