Assessment of pulmonary structure-function relationships in young children and adolescents with cystic fibrosis by multivolume proton-MRI and CT.
Assessment of pulmonary structure-function relationships in young children and adolescents with cystic fibrosis by multivolume proton-MRI and CT.
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DOI：
10.1002/jmri.25978
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发表时间：
2018-08
期刊：
影响因子：
--
通讯作者：
Woods JC
中科院分区：
文献类型：
--
作者：
Pennati F;Roach DJ;Clancy JP;Brody AS;Fleck RJ;Aliverti A;Woods JC
Lung disease is the most frequent cause of morbidity and mortality in patients with cystic fibrosis (CF), and there is a shortage of sensitive biomarkers able to regionally monitor disease progression and to assess early responses to therapy. To determine the feasibility of non-contrast enhanced multivolume MRI, which assesses intensity changes between expiratory and inspiratory breath-hold images, to detect and quantify regional ventilation abnormalities in CF lung disease, with a focus on structure-function relationship. Retrospective. 29 subjects, including healthy young children (n=9,7–37 months), healthy adolescents (n=4,14–22 years), young children with CF lung disease (n=10,7–47 months) and adolescents with CF lung disease (n=6,8–18 years) were studied. 3D spoiled gradient-recalled sequence at 1.5T. Subjects were scanned during breath-hold at functional residual capacity (FRC) and total lung capacity (TLC) through non-contrast enhanced MRI and CT. Expiratory-inspiratory differences in MR signal-intensity (Δ1H-MRI) and CT-density (ΔHU) were computed to estimate regional ventilation. MR and CT images were also evaluated using a CF-specific scoring system. quadratic regression, Spearman's correlation, One-way analysis of variance (ANOVA). Δ1H-MRI maps were sensitive to ventilation heterogeneity related to gravity dependence in healthy lung and to ventilation impairment in CF lung disease. An high correlation was found between MRI and CT ventilation maps (R2=0.79,p<0.001). Globally, Δ1H-MRI and ΔHU decrease with increasing morphological score (respectively, R2=0.56,p<0.001 and R2=0.31,p<0.001). Locally, Δ1H-MRI was higher in healthy regions (median 15%) compared to regions with bronchiectasis, air trapping and consolidation and to segments fed by airways with bronchial wall thickening (p<0.001). Non-contrast enhanced MRI, as a non-ionizing imaging modality that can be used on nearly any MRI scanner without specialized equipment or gaseous tracers, may be particularly valuable in CF care, providing a new imaging biomarker to detect early alterations in regional lung structure-function.
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