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J Allergy Clin Immunol. 2016 Mar;137(3):789-96.e7. doi: 10.1016/j.jaci.2015.08.045. Epub 2015 Oct 29.

Clinical correlates of lung ventilation defects in asthmatic children.

Author information

1
Department of Radiology, University of Missouri School of Medicine, Columbia, Mo.
2
Division of Medical Imaging Research, Department of Radiology and Medical Imaging, University of Virginia School of Medicine, Charlottesville, Va; Department of Biomedical Engineering, University of Virginia, Charlottesville, Va.
3
Center for Pulmonary Imaging Research, Cincinnati Children's Hospital, Cincinnati, Ohio.
4
Division of Medical Imaging Research, Department of Radiology and Medical Imaging, University of Virginia School of Medicine, Charlottesville, Va.
5
Child Health Research Center, Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, Va.
6
Child Health Research Center, Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, Va. Electronic address: wgt2p@virginia.edu.

Abstract

BACKGROUND:

Lung ventilation defects identified by using hyperpolarized 3-helium gas ((3)He) lung magnetic resonance imaging (MRI) are prevalent in asthmatic patients, but the clinical importance of ventilation defects is poorly understood.

OBJECTIVES:

We sought to correlate the lung defect volume quantified by using (3)He MRI with clinical features in children with mild and severe asthma.

METHODS:

Thirty-one children with asthma (median age, 10 years; age range, 3-17 years) underwent detailed characterization and (3)He lung MRI. Quantification of the (3)He signal defined ventilation defect and hypoventilated, ventilated, and well-ventilated volumes.

RESULTS:

The ventilation defect to total lung volume fraction ranged from 0.1% to 11.6%. Children with ventilation defect percentages in the upper tercile were more likely to have severe asthma than children in the lower terciles (P = .005). The ventilation defect percentage correlated (P < .05 for all) positively with the inhaled corticosteroid dose, total number of controller medications, and total blood eosinophil counts and negatively with the Asthma Control Test score, FEV1 (percent predicted), FEV1/forced vital capacity ratio (percent predicted), and forced expiratory flow rate from 25% to 75% of expired volume (percent predicted).

CONCLUSION:

The lung defect volume percentage measured by using (3)He MRI correlates with several clinical features of asthma, including severity, symptom score, medication requirement, airway physiology, and atopic markers.

KEYWORDS:

(3)He magnetic resonance imaging; Hyperpolarized; childhood asthma; severe asthma; ventilation defects; ventilation heterogeneity

PMID:
26521043
DOI:
10.1016/j.jaci.2015.08.045
[Indexed for MEDLINE]

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