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Assessment of pulmonary structure-function relationships in young children and adolescents with cystic fibrosis by multivolume proton-MRI and CT.
- Source :
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Journal of magnetic resonance imaging : JMRI [J Magn Reson Imaging] 2018 Aug; Vol. 48 (2), pp. 531-542. Date of Electronic Publication: 2018 Feb 19. - Publication Year :
- 2018
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Abstract
- Background: 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.<br />Purpose: To determine the feasibility of noncontrast-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 the structure-function relationship.<br />Study Type: Retrospective.<br />Population: Twenty-nine 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.<br />Field Strength/sequence: 3D spoiled gradient-recalled sequence at 1.5T.<br />Assessment: Subjects were scanned during breath-hold at functional residual capacity (FRC) and total lung capacity (TLC) through noncontrast-enhanced MRI and CT. Expiratory-inspiratory differences in MR signal-intensity (Δ <superscript>1</superscript> H-MRI) and CT-density (ΔHU) were computed to estimate regional ventilation. MR and CT images were also evaluated using a CF-specific scoring system.<br />Statistical Tests: Quadratic regression, Spearman's correlation, one-way analysis of variance (ANOVA).<br />Results: Δ <superscript>1</superscript> H-MRI maps were sensitive to ventilation heterogeneity related to gravity dependence in healthy lung and to ventilation impairment in CF lung disease. A high correlation was found between MRI and CT ventilation maps (R <superscript>2</superscript> = 0.79, P < 0.001). Globally, Δ <superscript>1</superscript> H-MRI and ΔHU decrease with increasing morphological score (respectively, R <superscript>2</superscript> = 0.56, P < 0.001 and R <superscript>2</superscript> = 0.31, P < 0.001). Locally, Δ <superscript>1</superscript> H-MRI was higher in healthy regions (median 15%) compared to regions with bronchiectasis, air trapping, consolidation, and to segments fed by airways with bronchial wall thickening (P < 0.001).<br />Data Conclusion: Multivolume noncontrast-enhanced MRI, as a nonionizing 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.<br />Level of Evidence: 3 Technical Efficacy: Stage 3 J. MAGN. RESON. IMAGING 2018;48:531-542.<br /> (© 2018 International Society for Magnetic Resonance in Medicine.)
- Subjects :
- Adolescent
Biomarkers
Child
Child, Preschool
Disease Progression
Female
Functional Residual Capacity
Humans
Infant
Male
Protons
Respiration
Respiratory Function Tests
Retrospective Studies
Total Lung Capacity
Young Adult
Cystic Fibrosis diagnostic imaging
Lung diagnostic imaging
Magnetic Resonance Imaging
Tomography, X-Ray Computed
Subjects
Details
- Language :
- English
- ISSN :
- 1522-2586
- Volume :
- 48
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Journal of magnetic resonance imaging : JMRI
- Publication Type :
- Academic Journal
- Accession number :
- 29457316
- Full Text :
- https://doi.org/10.1002/jmri.25978