MRI OF DIAPHRAGM ROLE IN CANDIDATE SCREENING FOR LUNG VOLUME REDUCTION SURGERY

本项目的目的是调查MRI是否 膈是有用的肺气肿患者肺的选择 减容手术（LVRS）。 假设是， LVRS对保留血管功能的患者的获益低于 失去了这个功能。 通过验证这一假设，我们希望 通过学习排除患者来改善整体手术结果 他们的横膈膜力学表明他们不太可能受益。 到目前为止，我们已经开发了一种MR协议，用于成像 动态地和在暂停呼吸期间的隔膜。 我们有 对7名对照受试者和4名 肺气肿病人 以这些初步数据为基础， 开发了软件分析工具来量化隔膜功能 形态测量学：面积、形状和运动。 我们做了一些推论 关于适应隔膜使慢性 恶性通货膨胀 我们术前研究的一名肺气肿患者 后来去了LVRS 我们计划重新研究那个病人， 在我们的一系列病人手术前后的影像中。 在未来一年，我们计划扩大一系列的控制， 和肺气肿的研究对象。 一旦有一部分患者， 已经研究过LVRS和术后康复，我们可以 开始搜索预测手术的术前MR参数 结果。 此外，对术后LVRS患者的研究将 允许测试我们的假设，在改善的患者中， LVRS后的功能状态，伴随着正常化 最重要的生物力学。

The purpose of this project is to investigate whether MRI of the diaphragm is useful in the selection of emphysema patients for lung volume reduction surgery (LVRS). The hypothesis is that patients who retain diaphragmatic function benefit less from LVRS than patients who have lost this function. By testing this hypothesis we hope to improve overall surgical outcomes by learning to exclude patients whose diaphragm mechanics indicates that they are unlikely to benefit. To date, we have developed an MR protocol for imaging the diaphragm both dynamically and during suspended respiration. We have performed diaphragmatic MRI studies on 7 control subjects and 4 emphysema patients. Using these preliminary data as a basis, we have developed software analysis tools to quantify diaphragm functional morphometry: area, shape, and movement. We have made some inferences concerning the adaptation which the diaphragm makes to chronic hyperinflation. One emphysema patient whom we studied preoperatively has since gone on to LVRS. We plan to restudy that patient, the first in our series of patients imaged before and after surgery. In the coming year, we plan to extend the series of control and emphysema subjects studied. As soon as a subset of patients we have studied has gone to LVRS and postoperative rehabilitation, we can begin the search for preoperative MR parameters which predict surgical outcome. In addition, the study of LVRS patients postoperatively will permit testing of our hypothesis that, in patients who have improved functional status following LVRS, there is a concomitant normalization of diaphragmatic biomechanics.