Virtual Bronchoscopy of Neonatal Airway Malacia via High-Resolution, Respiratory-gated Magnetic Resonance Imaging.
Virtual Bronchoscopy of Neonatal Airway Malacia via High-Resolution, Respiratory-gated Magnetic Resonance Imaging.
复制标题
通过高分辨率呼吸门控磁共振成像对新生儿气道软化症进行虚拟支气管镜检查。
DOI：
10.1164/rccm.202202-0362im
复制
发表时间：
2022
影响因子：
24.7
通讯作者：
Bates,AlisterJ
中科院分区：
文献类型：
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作者：
Higano,NaraS;Gandhi,DeepB;Xiao,Qiwei;Gunatilaka,ChaminduC;Hysinger,ErikB;Fleck,RobertJ;Woods,JasonC;Bates,AlisterJ
中央气道软化是支气管肺发育不良或先天性呼吸系统疾病早产儿的常见并发症，与住院时间延长和其他不良结局相关（5）。目前的评估方法（例如，侵入性支气管镜检查和电离X射线计算机断层扫描）对脆弱患者构成额外风险。我们演示视频1.动态气道的虚拟支气管镜“飞越”显示中下气管和右支气管软化，与临床支气管镜检查一致。患者的实际呼吸速率为66次呼吸/min，而动画虚拟视图出于显示目的减慢至15次呼吸/min。虚拟飞越视图允许评估新生儿气道异常，通过提供足够的中央气道时空分辨率，无需侵入性、电离、镇静或屏气程序，熟悉临床支气管镜检查的临床医生可以轻松解释新生儿气道异常。基于成像的虚拟支气管镜检查的局限性可以在主干支气管的生成之外看到;有限的成像分辨率（在这种情况下，0.7 3 0.7 3 0.7 mm）无法捕获较小的远端气道，因此排除了在前几代之外动画解剖表面所需的图像分割。
Central airway malacia is a common complication in preterm infants with bronchopulmonary dysplasia or congenital respiratory disorders and is associated with prolonged hospitalization and other poor outcomes (5). Current assessment methods (eg, invasive bronchoscopy and ionizing X-ray computed tomography) pose additional risks to vulnerable patients. We demonstrateVideo 1. The virtual bronchoscopy “fly-through” of the dynamic airway demonstrates malacia in the middle–lower trachea and right bronchus, in agreement with clinical bronchoscopy. The patient’s actual respiratory rate was 66 breaths/min, while the animated virtual view is slowed to 15 breaths/min for display purposes. The virtual fly-through view allows for the assessment of neonatal airway abnormalities that is readily interpretable to clinicians familiar with clinical bronchoscopy by providing sufficient spatiotemporal resolution of the central airway without requiring invasive, ionizing, sedated, or breath-holding procedures. A limitation of imaging-based virtual bronchoscopy can be seen beyond the generation of the main stem bronchi; finite imaging resolution (in this case, 0.7 3 0.7 3 0.7 mm) is not able to capture smaller distal airways and thus precludes the necessary image segmentation for animating the anatomical surface beyond the first few generations.