The Clinical Use of Lung MRI in Cystic Fibrosis: What, Now, How?
The Clinical Use of Lung MRI in Cystic Fibrosis: What, Now, How?
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DOI：
10.1016/j.chest.2020.12.008
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发表时间：
2021-06
期刊：
影响因子：
9.6
通讯作者：
Woods JC
中科院分区：
文献类型：
--
作者：
Dournes G;Walkup LL;Benlala I;Willmering MM;Macey J;Bui S;Laurent F;Woods JC
为了无创地评估囊性纤维化(CF)的呼吸道和肺实质损害，胸部MRI历来被排除在常规临床成像的范围之外，因为技术上的困难，如低质子密度和呼吸和心脏运动。然而，已经出现了显著提高肺部MRI质量(包括信噪比、分辨率、速度和对比度)的技术突破。与此同时，新的治疗方法改变了CF临床护理的格局。在这种当代背景下，现在已经达成共识，即肺MRI可以用于临床，以无辐射的方式评估CF，并能够量化肺部疾病的严重程度。MRI现在可以实现三维、高分辨率的形态成像，除了这些形态信息，MRI还可以提供敏感地区分活动性炎症和瘢痕组织的能力。MRI还可以定性各种形式的炎症，以早期指导治疗。此外，MRI的功能信息可用于评估区域性小气道疾病，甚至在轻度CF患者中也能灵敏地检测出微小的变化。最后，自动化量化方法已经出现，以支持传统的视觉分析，以更客观和可重复地评估疾病严重程度。本文旨在综述肺MRI的最新进展，重点介绍肺纤维化的实际应用和临床价值，以及这些现代技术的融合和对患者护理的影响。
To assess airway and lung parenchymal damage noninvasively in cystic fibrosis (CF), chest MRI has been historically out of the scope of routine clinical imaging because of technical difficulties such as low proton density and respiratory and cardiac motion. However, technological breakthroughs have emerged that dramatically improve lung MRI quality (including signal-to-noise ratio, resolution, speed, and contrast). At the same time, novel treatments have changed the landscape of CF clinical care. In this contemporary context, there is now consensus that lung MRI can be used clinically to assess CF in a radiation-free manner and to enable quantification of lung disease severity. MRI can now achieve three-dimensional, high-resolution morphologic imaging, and beyond this morphologic information, MRI may offer the ability to sensitively differentiate active inflammation vs scarring tissue. MRI could also characterize various forms of inflammation for early guidance of treatment. Moreover, functional information from MRI can be used to assess regional, small-airway disease with sensitivity to detect small changes even in patients with mild CF. Finally, automated quantification methods have emerged to support conventional visual analyses for more objective and reproducible assessment of disease severity. This article aims to review the most recent developments of lung MRI, with a focus on practical application and clinical value in CF, and the perspectives on how these modern techniques may converge and impact patient care soon.
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影响因子：
6.1
作者：
Agarwal, R.;Chakrabarti, A.;Denning, D. W.
通讯作者：
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影响因子：
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DOI：
10.1164/ajrccm.156.4.96-11058
发表时间：
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DOI：
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发表时间：
2020-06
期刊：
The Indian journal of medical research
影响因子：
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作者：
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影响因子：
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作者：
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