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Eur Respir J. 2019 Feb 28. pii: 1702020. doi: 10.1183/13993003.02020-2017. [Epub ahead of print]

Quantitative multivolume proton-MRI in patients with cystic fibrosis lung disease: comparison with clinical indicators.

Author information

1
Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milano, Italy.
2
Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Radiologia Pediatrica, Milano, Italy.
3
Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, U.O.C. Direzione Professioni Sanitarie, Milano, Italy.
4
Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Centro Fibrosi Cistica, Milano, Italy.

Abstract

OBJECTIVES:

The present cross-sectional study aims to verify the relationship between quantitative multivolume magnetic resonance imaging (MRI) and clinical indicators of ventilatory abnormalities in cystic fibrosis (CF) lung disease.

METHODS:

28 patients (10-27 years) with CF lung disease performed non-enhanced chest MRI, spirometry and multiple breath washout (MBW). Images acquired at end-inspiration and end-expiration were registered by optical flow to estimate expiratory-inspiratory proton density change (Δ1H-MRI) as a measure of regional ventilation. MR images were also evaluated using a CF-specific scoring system.

RESULTS:

Biomarkers of CF ventilation impairment were defined from Δ1H-MRI: Δ1H-MRI median, Δ1H-MRI quartile coefficient of variation (QCV) and percent low-ventilation volume (%LVV). Imaging biomarkers correlate to all the clinical measures of ventilation abnormalities, with the strongest correlation between Δ1H-MRI median and forced expiratory volume in one second (FEV1) (r2=0.44, p<0.001), Δ1H-MRI QCV and lung clearance index (LCI) (r2=0.51, p<0.001) and %LVV and LCI (r2=0.66, p<0.001). Correlations were also found between imaging biomarkers of ventilation and morphological scoring.

CONCLUSION:

The study showed a significant correlation between quantitative multivolume-MRI and clinical indicators of CF lung disease. MRI, as a non-ionizing imaging technique, may be particularly attractive in CF care for longitudinal evaluation, providing a new imaging biomarker to detect early ventilator abnormalities.

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