Hyperpolarized Gas Magnetic Resonance Lung Imaging in Children and Young Adults.
Hyperpolarized Gas Magnetic Resonance Lung Imaging in Children and Young Adults.
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DOI：
10.1097/rti.0000000000000218
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发表时间：
2016-09
影响因子：
3.3
通讯作者：
Altes TA
中科院分区：
文献类型：
--
作者：
Flors L;Mugler JP 3rd;de Lange EE;Miller GW;Mata JF;Tustison N;Ruset IC;Hersman FW;Altes TA
对儿童来说，评估早期肺部疾病及其严重程度可能很困难，因为他们往往不能进行肺活量测定等程序。计算机断层扫描提供了肺实质的详细结构图像，但其主要缺点是患者暴露在电离辐射中。在此背景下，MRI是一种很有前途的评估儿童肺部疾病的技术，特别是当需要进行系列成像的时候。传统上，MRI对肺实质的评价作用不大。由于其低质子密度，肺部在常规质子磁共振成像上表现为低信号。超极化(HP)气体是一种吸入造影剂，具有极好的安全性，在肺内提供高信号，允许对肺空间进行高时间和空间分辨率成像。除了形态信息外，HP MR图像还提供了有关肺生理的有价值的信息。HP GAS MRI对儿童肺部疾病的认识已有新的贡献，有可能成为一种临床有用的工具。在这篇文章中，我们讨论了HP GAS MRI技术，在为儿童成像时需要考虑的特殊考虑，以及MRI在两种最常见的慢性儿童肺部疾病-哮喘和囊性纤维化中的作用。我们还将讨论如何使用HP GAS MRI来评估正常的肺生长发育，以及早产儿慢性肺部疾病和先天性横隔疝患者所发生的改变。
The assessment of early pulmonary disease and its severity can be difficult in children as they often cannot perform procedures such as spirometry. Computed tomography provides detailed structural images of the pulmonary parenchyma but its major drawback is that the patient is exposed to ionizing radiation. In this context, MRI is a promising technique for the evaluation of pediatric lung disease, especially when serial imaging is needed. Traditionally, MRI played a small role in evaluating the pulmonary parenchyma. Because of its low proton density, the lungs display low signal intensity on conventional proton-based MRI. Hyperpolarized (HP) gases are inhaled contrast agents with an excellent safety profile and provide high signal within the lung allowing for high temporal and spatial resolution imaging of the lung airspaces. Besides morphological information, HP MR images also offer valuable information about pulmonary physiology. HP gas MRI has already made new contributions to the understanding of pediatric lung diseases and may become a clinically useful tool. In this article, we discuss the HP gas MRI technique, special considerations that need to be considered when imaging children, and the role of MRI in two of the most common chronic pediatric lung diseases, asthma and cystic fibrosis. We also will discuss how HP gas MRI may be used to evaluate normal lung growth and development, and the alterations occurring in chronic lung disease of prematurity and in patients with a congenital diaphragmatic hernia.