Format

Send to

Choose Destination
J Magn Reson Imaging. 2018 Aug;48(2):531-542. doi: 10.1002/jmri.25978. Epub 2018 Feb 19.

Assessment of pulmonary structure-function relationships in young children and adolescents with cystic fibrosis by multivolume proton-MRI and CT.

Author information

1
Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milano, Italy.
2
Center for Pulmonary Imaging Research, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
3
Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
4
Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.

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.

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.

STUDY TYPE:

Retrospective.

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.

FIELD STRENGTH/SEQUENCE:

3D spoiled gradient-recalled sequence at 1.5T.

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 (Δ1 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.

STATISTICAL TESTS:

Quadratic regression, Spearman's correlation, one-way analysis of variance (ANOVA).

RESULTS:

Δ1 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 (R2  = 0.79, P < 0.001). Globally, Δ1 H-MRI and ΔHU decrease with increasing morphological score (respectively, R2  = 0.56, P < 0.001 and R2  = 0.31, P < 0.001). Locally, Δ1 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).

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.

LEVEL OF EVIDENCE:

3 Technical Efficacy: Stage 3 J. MAGN. RESON. IMAGING 2018;48:531-542.

KEYWORDS:

cystic fibrosis; lung; pediatrics

PMID:
29457316
PMCID:
PMC6098984
[Available on 2019-08-01]
DOI:
10.1002/jmri.25978

Supplemental Content

Full text links

Icon for Wiley
Loading ...
Support Center