Evaluation of asthma with hyperpolarized helium-3 MRI - Correlation with clinical severity and spirometry
Evaluation of asthma with hyperpolarized helium-3 MRI - Correlation with clinical severity and spirometry
复制标题
DOI：
10.1378/chest.130.4.1055
复制
发表时间：
2006-10-01
期刊：
影响因子：
9.6
通讯作者：
Platts-Mills, Thomas A.
中科院分区：
文献类型：
--
作者：
de lange, Eduard E.;Altes, Talissa A.;Platts-Mills, Thomas A.
背景：由于症状的可变性，准确描述哮喘严重程度很困难。超极化氦 3 MRI ((HHeMR)-He-3) 是一种将空域可视化的新技术，将气流阻塞的区域描绘为“通风缺陷”。本研究的目的是将 (HHeMR)-He-3 通气缺陷的程度与哮喘严重程度和肺活量测定进行比较。方法：医生诊断为哮喘的患者和正常对照受试者接受 (HHeMR)-He-3 治疗。对每个人的通气缺陷的数量和大小进行评分，并计算每层通气缺陷的平均数量（VDS）。确定影像学检查结果与哮喘严重程度和肺活量测量结果的相关性。 结果：有 58 名哮喘患者（轻度间歇性，n = 13；轻度持续性，n = 13；中度持续性，n = 20；重度持续性，n = 12）和 18 名对照受试者。哮喘患者的平均 +/- SE VDS 显着高于对照组（0.99 +/- 0.15 vs; 0.26 +/- 0.22，p = 0.004）。在哮喘患者中，中度持续性和重度持续性疾病组的 VDS 显着高于轻度间歇性和轻度持续性疾病组（1.37 +/- 0.24 vs 0.53 +/- 0.12，p < 0.001）。 VDS 与 FEV1/FVC 显着相关（r = -0.51，p = 0.002），从 FVC 开始时用力呼气流量在 25% 到 75% 之间 (FEF25-75%) 身高、性别和种族预测百分比（%预测）[r = -0.50，p = 0.001]，以及 FEV1 预测百分比（r = -0.40，p = 0.002)，但不是 FVC %预测 (r = -0.26, p = 0.057) 和峰值呼气流量 %预测 (r = -0.16, p = 0.231)。许多哮喘患者的 VDS 升高，但除 FEF25%-75% 外，他们的肺活量指数均正常。所有哮喘患者的大多数通气缺陷的大小都小于 3 厘米。中度至重度持续性哮喘患者组中，>= 3 cm 的缺陷多于轻度间歇性和轻度持续性哮喘患者组 (p = 0.021)。结论： (HHeMR)-He-3 描述的哮喘患者气流阻塞的区域变化与哮喘严重程度和肺活量测定相关。
Background: Accurate characterization of asthma severity is difficult due to the variability of symptoms. Hyperpolarized helium-3 MRI ((HHeMR)-He-3) is a new technique in which the airspaces are visualized, depicting regions with airflow obstruction as "ventilation defects." The objective of this study was to compare the extent of (HHeMR)-He-3 ventilation defects with measures of asthma severity and spirometry.Methods: Patients with a physician diagnosis of asthma and normal control subjects underwent (HHeMR)-He-3. For each person, the number and size of ventilation defects were scored and the average number of ventilation defects per slice (VDS) was calculated. The correlations of the imaging findings with measures of asthma severity and spirometry were determined.Results: There were 58 patients with asthma (mild-intermittent, n = 13; mild-persistent, n = 13; moderate-persistent, n = 20; and severe-persistent, n = 12) and 18 control subjects. Mean +/- SE VDS for asthmatics was significantly greater than for control subjects (0.99 +/- 0.15 vs; 0.26 +/- 0.22, p = 0.004). Among asthmatics, VDS was significantly higher for the group with moderate-persistent and severe-persistent disease than for the group with mild-intermittent and mild-persistent disease (1.37 +/- 0.24 vs 0.53 +/- 0.12, p < 0.001). VDS correlated significantly with FEV1/FVC (r = -0.51, p = 0.002), forced expiratory flow between 25% and 75% from the beginning of FVC (FEF25-75%) percentage of predicted for height, sex, and race (%predicted) [r = -0.50, p = 0.001], and FEV1 %predicted (r = -0.40, p = 0.002), but not with FVC %predicted (r = -0.26, p = 0.057) and peak expiratory flow %predicted (r = -0.16, p = 0.231). Many asthmatics had an elevated VDS, but their spirometric indexes, except FEF25%-75%, were normal. Most ventilation defects were < 3 cm in size for all asthmatics. In the group of patients with moderate-to-severe persistant asthma, there were more defects >= 3 cm than in the group with mild-intermittent and mild-persistent disease (p = 0.021).Conclusions: Regional changes of airflow obstruction in asthmatics depicted by (HHeMR)-He-3 correlate with measures of asthma severity and spirometry.