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Pulmonary 3He Magnetic Resonance Imaging Biomarkers of Regional Airspace Enlargement in Alpha-1 Antitrypsin Deficiency.
Lessard, Eric; Young, Heather M; Bhalla, Anurag; Pike, Damien; Sheikh, Khadija; McCormack, David G; Ouriadov, Alexei; Parraga, Grace.
Afiliação
  • Lessard E; Robarts Research Institute, 1151 Richmond Street North, London, ON, Canada N6A 5B7; Department of Medical Biophysics, The University of Western Ontario, 1151 Richmond St North, London, ON, Canada N6A 5C1.
  • Young HM; Robarts Research Institute, 1151 Richmond Street North, London, ON, Canada N6A 5B7; Department of Medical Biophysics, The University of Western Ontario, 1151 Richmond St North, London, ON, Canada N6A 5C1.
  • Bhalla A; Robarts Research Institute, 1151 Richmond Street North, London, ON, Canada N6A 5B7.
  • Pike D; Robarts Research Institute, 1151 Richmond Street North, London, ON, Canada N6A 5B7; Department of Medical Biophysics, The University of Western Ontario, 1151 Richmond St North, London, ON, Canada N6A 5C1.
  • Sheikh K; Robarts Research Institute, 1151 Richmond Street North, London, ON, Canada N6A 5B7; Department of Medical Biophysics, The University of Western Ontario, 1151 Richmond St North, London, ON, Canada N6A 5C1.
  • McCormack DG; Division of Respirology, Department of Medicine, The University of Western Ontario, London, Ontario, Canada.
  • Ouriadov A; Robarts Research Institute, 1151 Richmond Street North, London, ON, Canada N6A 5B7; Department of Medical Biophysics, The University of Western Ontario, 1151 Richmond St North, London, ON, Canada N6A 5C1.
  • Parraga G; Robarts Research Institute, 1151 Richmond Street North, London, ON, Canada N6A 5B7; Department of Medical Biophysics, The University of Western Ontario, 1151 Richmond St North, London, ON, Canada N6A 5C1. Electronic address: gparraga@robarts.ca.
Acad Radiol ; 24(11): 1402-1411, 2017 11.
Article em En | MEDLINE | ID: mdl-28645458
ABSTRACT
RATIONALE AND

OBJECTIVES:

Thoracic x-ray computed tomography (CT) and hyperpolarized 3He magnetic resonance imaging (MRI) provide quantitative measurements of airspace enlargement in patients with emphysema. For patients with panlobular emphysema due to alpha-1 antitrypsin deficiency (AATD), sensitive biomarkers of disease progression and response to therapy have been difficult to develop and exploit, especially those biomarkers that correlate with outcomes like quality of life. Here, our objective was to generate and compare CT and diffusion-weighted inhaled-gas MRI measurements of emphysema including apparent diffusion coefficient (ADC) and MRI-derived mean linear intercept (Lm) in patients with AATD, chronic obstructive pulmonary disease (COPD) ex-smokers, and elderly never-smokers. MATERIALS AND

METHODS:

We enrolled patients with AATD (n = 8; 57 ± 7 years), ex-smokers with COPD (n = 8; 77 ± 6 years), and a control group of never-smokers (n = 5; 64 ± 2 years) who underwent thoracic CT, MRI, spirometry, plethysmography, the St. George's Respiratory Questionnaire, and the 6-minute walk test during a single 2-hour visit. MRI-derived ADC, Lm, surface-to-volume ratio, and ventilation defect percent were generated for the apical, basal, and whole lung as was CT lung area ≤-950 Hounsfield units (RA950), low attenuating clusters, and airway count.

RESULTS:

In patients with AATD, there was a significantly different MRI-derived ADC (P = .03), Lm (P < .0001), and surface-to-volume ratio (P < .0001), but not diffusing capacity of carbon monoxide, residual volume or total lung capacity, or CT RA950 (P > .05) compared to COPD ex-smokers with a significantly different St. George's Respiratory Questionnaire.

CONCLUSIONS:

In this proof-of-concept demonstration, we evaluated CT and MRI lung emphysema measurements and observed significantly worse MRI biomarkers of emphysema in patients with AATD compared to patients with COPD, although CT RA950 and diffusing capacity of carbon monoxide were not significantly different, underscoring the sensitivity of MRI measurements of AATD emphysema.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Enfisema Pulmonar / Imageamento por Ressonância Magnética / Tomografia Computadorizada por Raios X / Deficiência de alfa 1-Antitripsina / Imagem de Difusão por Ressonância Magnética Tipo de estudo: Etiology_studies Limite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2017 Tipo de documento: Article
Texto completo
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XML
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Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Enfisema Pulmonar / Imageamento por Ressonância Magnética / Tomografia Computadorizada por Raios X / Deficiência de alfa 1-Antitripsina / Imagem de Difusão por Ressonância Magnética Tipo de estudo: Etiology_studies Limite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2017 Tipo de documento: Article