In Vivo Dark-Field Radiography for Early Diagnosis and Staging of Pulmonary Emphysema
In Vivo Dark-Field Radiography for Early Diagnosis and Staging of Pulmonary Emphysema
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DOI：
10.1097/rli.0000000000000147
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发表时间：
2015-07-01
影响因子：
6.7
通讯作者：
Pfeiffer, Franz
中科院分区：
文献类型：
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作者：
Hellbach, Katharina;Yaroshenko, Andre;Pfeiffer, Franz
目的评价在体X线暗场摄影对小鼠肺气肿早期诊断的适用性。此外，我们的目的是分析如何暗场信号与肺结构的形态学变化在不同阶段的emphysema.Materials和MethodsFemale 8至10周龄的C57 Bl/6 N小鼠在整个实验中使用。通过经口气管注射猪胰弹性蛋白酶（80-U/kg体重）诱导肺气肿（n = 30）。对照组小鼠（n = 11）经口气管注射磷酸盐缓冲盐水。为了监测肺气肿随时间发展的时间模式，在应用弹性蛋白酶或磷酸盐缓冲盐水后7、14或21天对小鼠进行成像。X射线透射和暗场图像采集与原型光栅为基础的小动物扫描仪。在处死动物之前进行体内肺功能测试。此外，获得肺用于详细的组织病理学分析，包括平均脊髓长度（MCL）定量作为评估肺气肿的参数。三个盲读者，他们都有经验的放射科医生和熟悉的暗场成像，被要求分级肺气肿的严重程度为暗场和transmission images. ResultsHistorology和MCL量化证实了引入不同阶段的肺气肿，这可以清楚地可视化和区分的暗场射线照片，而早期阶段没有检测到的透射图像。MCL与暗场信号强度的相关性（r = 0.85）显著高于MCL与透射信号强度的相关性（r = 0.37）。读片者对暗场图像的视觉评级与MCL的相关性（r = 0.85）显著优于对透射图像的视觉评级（r = 0.36）。阅片者之间的一致性和诊断准确性的定量和视觉评估显着较高的暗场成像比那些传统的transmission images. ConclusionsX射线暗场摄影可以可靠地可视化不同阶段的肺气肿在体内，并表现出显着较高的诊断准确性肺气肿的早期阶段比传统的衰减为基础的放射摄影。
ObjectivesThe aim of this study was to evaluate the suitability of in vivo x-ray dark-field radiography for early-stage diagnosis of pulmonary emphysema in mice. Furthermore, we aimed to analyze how the dark-field signal correlates with morphological changes of lung architecture at distinct stages of emphysema.Materials and MethodsFemale 8- to 10-week-old C57Bl/6N mice were used throughout all experiments. Pulmonary emphysema was induced by orotracheal injection of porcine pancreatic elastase (80-U/kg body weight) (n = 30). Control mice (n = 11) received orotracheal injection of phosphate-buffered saline. To monitor the temporal patterns of emphysema development over time, the mice were imaged 7, 14, or 21 days after the application of elastase or phosphate-buffered saline. X-ray transmission and dark-field images were acquired with a prototype grating-based small-animal scanner. In vivo pulmonary function tests were performed before killing the animals. In addition, lungs were obtained for detailed histopathological analysis, including mean cord length (MCL) quantification as a parameter for the assessment of emphysema. Three blinded readers, all of them experienced radiologists and familiar with dark-field imaging, were asked to grade the severity of emphysema for both dark-field and transmission images.ResultsHistopathology and MCL quantification confirmed the introduction of different stages of emphysema, which could be clearly visualized and differentiated on the dark-field radiograms, whereas early stages were not detected on transmission images. The correlation between MCL and dark-field signal intensities (r = 0.85) was significantly higher than the correlation between MCL and transmission signal intensities (r = 0.37). The readers' visual ratings for dark-field images correlated significantly better with MCL (r = 0.85) than visual ratings for transmission images (r = 0.36). Interreader agreement and the diagnostic accuracy of both quantitative and visual assessment were significantly higher for dark-field imaging than those for conventional transmission images.ConclusionsX-ray dark-field radiography can reliably visualize different stages of emphysema in vivo and demonstrates significantly higher diagnostic accuracy for early stages of emphysema than conventional attenuation-based radiography.