Functional analysis in single-lung transplant recipients -: A comparative study of high-resolution CT, 3He-MRI, and pulmonary function tests
Functional analysis in single-lung transplant recipients -: A comparative study of high-resolution CT, 3He-MRI, and pulmonary function tests
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DOI：
10.1378/chest.125.1.173
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发表时间：
2004-01-01
期刊：
影响因子：
9.6
通讯作者：
Kauczor, HU
中科院分区：
文献类型：
--
作者：
Zaporozhan, J;Ley, S;Kauczor, HU
目的：目的：开发和评价一种基于He-3-MRI的后处理工具，以量化通气分肺体积，并将其应用于单肺移植（SLTX）后的患者。采用高分辨率CT（HRCT）作为参考模式，提供分离的充气肺体积。从肺功能测试结果得出的肺体积作为临床参数，并被用作“金标准”。材料和方法：8例肺气肿患者（平均年龄54岁）和6例特发性肺纤维化患者（平均年龄58岁）。所有患者均在SLTX后进行评价。吸气期间进行HRCT（层厚，1 mm;增量，10 mm）。为与He-3-MRI进行对比，HRCT图像在冠状方向上进行重建，以匹配相同的解剖水平。充气肺由CT的基于阈值的分割确定。在1.5 T扫描仪上进行He-3-MRI，在吸入300 mL超极化He-3气体后，使用二维快速低角度拍摄序列，冠状方向覆盖整个肺，然后在潮气量的其余部分使用正常室内空气。结果：在肺气肿患者中，He-3-MRI与肺活量相关性良好（r = 0.9），而CT与总肺活量相关（r = 0.8）。对于移植物和自体纤维化肺，He-3-MRI与CT具有良好的相关性（r > 0.8）。在肺气肿肺，MRI显示了良好的相关性（r = 0.7）与非肺气肿肺体积从CT。He-3-MRI中阈值的增加揭示了肺气肿和纤维化中通气和通气肺区域的不同分布差异。结论：He-3-MRI在肺气肿中显示参与气体交换的通气肺区域优于CT，具有上级优势。在纤维化中，He-3-MRI和CT具有类似的影响。降低模式和自体肺和移植肺通气之间的个体内比率将作为接受SLTX的患者的解释性随访的新替代物进行研究。
Objective: To develop and evaluate a postprocessing tool to quantify ventilated split-lung volumes on the basis of He-3-MRI and to apply it in patients after single-lung transplantation (SLTX). High-resolution CT (HRCT) was employed as a reference modality providing split air-filled lung volumes. Lung volumes derived from pulmonary function test results served as clinical parameters and were used as the "gold standard."Material and methods: Eight patients (mean age, 54 years) with emphysema and six patients (mean age, 58 years) with idiopathic pulmonary fibrosis. All patients were evaluated following SLTX. HRCT was performed during inspiration (slice thickness, I mm; increment, 10 mm). For correlation with He-3-MRI, HRCT images were reconstructed In coronal orientation to match the same anatomic levels. Aerated lung was determined by threshold-based segmentation of CT. He-3-MRI was performed on a 1.5-T scanner using a two-dimensional, fast low-angle shot sequence in coronal orientation covering the whole lung after inhalation of a 300-mL bolus of hyperpolarized He-3 gas followed by normal room air for the rest of the tidal volume. Lung segmentation on He-3-MRI was done using different thresholds;Results: In emphysematous patients, He-3-MRI showed excellent correlation (r = 0.9),with vital capacity, while CT correlated (r = 0.8) with total lung capacity. He-3-MRI correlated well with CT (r > 0.8) for grafts and native fibrotic lungs. In emphysematous lungs, MRI showed a good correlation (r = 0.7) with the nonemphysematous lung volume from CT. Increasing thresholds in He-3-MRI reveal differences between aerated and ventilated lung areas with a different distribution in emphysema and fibrosis.Conclusions: He-3-MRI is superior to CT in emphysema to demonstrate ventilated lung areas that participate in gas exchange. In fibrosis, He-3-MRI and CT have a similar impact. The decrease pattern and the intraindividual ratio between ventilation of native and transplanted lungs will have to be investigated as a new surrogate for the ventilatory follow-up in patients undergoing SLTX.