Quantitatively assessed dynamic contrast-enhanced magnetic resonance imaging in patients with chronic obstructive pulmonary disease: Correlation of perfusion parameters with pulmonary function test and quantitative computed tomography
Quantitatively assessed dynamic contrast-enhanced magnetic resonance imaging in patients with chronic obstructive pulmonary disease: Correlation of perfusion parameters with pulmonary function test and quantitative computed tomography
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DOI：
10.1097/rli.0b013e31816901ab
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发表时间：
2008-06-01
影响因子：
6.7
通讯作者：
Lee, Sang Do
中科院分区：
文献类型：
--
作者：
Jang, Yu Mi;Oh, Yeon-Mok;Lee, Sang Do
目的：本研究的目的是评估慢性阻塞性肺疾病（COPD）患者的三维对比增强磁共振（MR）成像（3D CEMRI）灌注参数与肺功能测试（PFT）和定量计算机断层扫描（CT）参数的相关性。材料和方法：对14例COPD患者进行3D CEMRI。根据信号强度-时间曲线，计算每个像素的肺血流量（PBF）、肺血容量（PBV）和平均通过时间。根据体积 CT 数据，评估了定量参数，包括低于 -950 Housefield 单位 (V-950) 的肺体积分数和平均肺密度。使用 Spearman 相关分析评估 MR 灌注参数与定量 CT 和 PFT 参数之间的相关性。由2名读者采用4级视觉评分法定性评估每位患者MR灌注图上的灌注区域受损与定量CT图上的肺气肿区域的对应关系。结果：所有3D CEMRI检查均顺利完成，并获得了所有患者的MR灌注参数。 Spearman相关性检验显示，PBF与1秒用力呼气量（FEV1）/用力肺活量（FVC）呈正相关（R=0.49，P=0.044），PBV与FEV1/FVC呈正相关（R=0.69，P=0.006），与V-950呈负相关（R=-0.61，P=0.020），平均通过时间与 FEV1 (R = 0.63, P = 0.017) 和 FEV1/FVC (R = 0.76, P = 0.002) 呈正相关。 PBF 和 PBV 图上的灌注损伤面积与 CT 图上的肺气肿面积相关性相对较好[非常好或好：PBF 71.5%（读者 1）和 64.3%（读者 2）的患者，kappa = 0.47（P < 0,001）； PBV 78.6%（读者 1）和 78.6%（读者 2）的患者，kappa = 0.89 (P < 0.001)]。结论：本研究表明，COPD 患者 MR 测量的灌注参数恶化，与 PFT 气流受限和 CT 肺气肿指数恶化相关。 CT 上肺气肿的区域异质性与 MR 上灌注减少相匹配。
Objectives: The purpose of this study is to evaluate the correlation of the perfusion parameters of 3-dimensional, contrast-enhanced magnetic resonance (MR) imaging (3D CEMRI) with pulmonary function test (PFT) and quantitative computed tomography (CT) parameters in patients with chronic obstructive pulmonary disease (COPD).Materials and Methods: In 14 patients with COPD, 3D CEMRI was performed. From the signal intensity-time curves, pulmonary blood flow (PBF), pulmonary blood volume (PBV), and mean transit time of each pixel was calculated. From the volumetric CT data, the quantitative parameters including the volume fraction of the lung below -950 Housefield Units (V-950) and mean lung density were assessed. The correlation between the MR perfusion parameters and the parameters from quantitative CT and PFT was assessed using Spearman correlation analysis. The correspondence of the regional impairment of perfusion on MR perfusion maps to the areas of emphysema on quantitative CT maps in each patient was assessed qualitatively using a 4-class visual scoring method by 2 readers.Results: All 3D CEMRI examinations were successfully completed and MR perfusion parameters were obtained in all patients. The Spearman correlation test showed that PBF positively correlated with forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) (R = 0.49, P = 0.044), PBV positively correlated with FEV1/FVC (R = 0.69, P = 0.006) and negatively correlated with V-950 (R = -0.61, P = 0.020), and mean transit time positively correlated with FEV1 (R = 0.63, P = 0.017) and FEV1/FVC (R = 0.76, P = 0.002). The areas of perfusion impairment on PBF and PBV maps were relatively well correlated with the areas of emphysema on CT maps [very good or good: PBF 71.5% (reader 1) and 64.3% (reader 2) of the patients, kappa = 0.47 (P < 0,001); PBV 78.6% (reader 1) and 78.6% (reader 2) of the patients, kappa = 0.89 (P < 0.001)].Conclusions: This study shows that the deterioration of perfusion parameters measured on MR in patients with COPD, correlates with worsening of airflow limitation on PFT and emphysema index on CT. Regional heterogeneity of emphysema on CT matches with the decreased perfusion on MR.