The variability of regional airflow obstruction within the lungs of patients with asthma: Assessment with hyperpolarized helium-3 magnetic resonance imaging

被引:132
作者
de Lange, Eduard E.
Altes, Talissa A.
Patrie, James T.
Parmar, Jaywant
Brookeman, James R.
Mugler, John P., III
Platts-Mills, Thomas A. E.
机构
[1] Univ Virginia, Hlth Sci Syst, Dept Radiol, Div Asthma Allergy & Immunol, Charlottesville, VA 22908 USA
[2] Univ Virginia, Dept Hlth Evaluat Sci, Div Asthma Allergy & Immunol, Charlottesville, VA 22908 USA
[3] Univ Virginia, Dept Internal Med, Div Asthma Allergy & Immunol, Charlottesville, VA 22908 USA
关键词
airflow obstruction; airway asthma; bronchial activity; hyperpolarized gases; hyperpolarized helium-3; pulmonary function; spirometry; magnetic resonance imaging; MRI; ventilation defect; ventilation; lung diseases; THIN-SECTION CT; EXERCISE CHALLENGE; METHACHOLINE; VENTILATION; VOLUME; GAS; MRI; HYPERREACTIVITY; CLOSURE; AIRWAYS;
D O I
10.1016/j.jaci.2006.12.659
中图分类号
R392 [医学免疫学];
学科分类号
100102 ;
摘要
Background: It is unknown whether focal changes of airflow obstruction within the lungs of patients with asthma vary or are fixed in location with time or repeated bronchoconstriction. With hyperpolarized helium-3 magnetic resonance ((HHeMR)-He-3) imaging, the airspaces are depicted and focal areas of airflow obstruction are shown as "ventilation defects." Objective: To investigate the regional changes of airflow obstruction with time and repeated bronchoconstriction. Methods: (HHeMR)-He-3 and spirometry were performed before (pre) and immediately after (post) methacholine challenge in 10 young patients with asthma on 2 days that were 7-476 days (mean, 185.3 +/- 37.2 days) apart. Pair-wise image comparisons were performed to determine the change in location of ventilation defects within the lung and their change in size. Results: When comparing premethacholine versus premethacholine and postmetbacholine versus postmethacholine images of the 2 days, 41% +/- 10% and 69% +/- 5% (P = .017) of defects, respectively, were in the same location, and of those, 69% +/- 12 % and 43% +/- 5 % (P = .022), respectively, did not change size. Comparing premethacholine versus postmethacholine images, 58% +/- 9% of defects were in the same location on day I and 73% +/- 7% (P = .088) on day 2. On both days, the percent increase in defect number from premethacholine to postmethacholine was much greater than the percent decrease in spirometric values (P < .001). Conclusion: Many of the ventilation defects persisted or recurred in the same location with time or repeated bronchoconstriction, suggesting that the regional changes of airflow obstruction are relatively fixed within the lung. Clinical implications: The findings give new insight into the regional airflow variability within the lungs of patients with asthma.
引用
收藏
页码:1072 / 1078
页数:7
相关论文
共 28 条
[1]   Hyperpolarized 3He MR lung ventilation imaging in asthmatics:: Preliminary findings [J].
Altes, TA ;
Powers, PL ;
Knight-Scott, J ;
Rakes, G ;
Platts-Mills, TAE ;
de Lange, EE ;
Alford, BA ;
Mugler, JP ;
Brookeman, JR .
JOURNAL OF MAGNETIC RESONANCE IMAGING, 2001, 13 (03) :378-384
[2]   Air trapping on expiratory high-resolution CT scans in the absence of inspiratory scan abnormalities: Correlation with pulmonary function tests and differential diagnosis [J].
Arakawa, H ;
Webb, WR .
AMERICAN JOURNAL OF ROENTGENOLOGY, 1998, 170 (05) :1349-1353
[3]   Mild intermittent asthma: CT assessment of bronchial cross-sectional area and lung attenuation at controlled lung volume [J].
Beigelman-Aubry, C ;
Capderou, A ;
Grenier, PA ;
Straus, C ;
Becquemin, MH ;
Similowski, T ;
Zelter, M .
RADIOLOGY, 2002, 223 (01) :181-187
[4]   Lung function decline in bronchial asthma [J].
Cibella, F ;
Cuttitta, G ;
Bellia, V ;
Bucchieri, S ;
D'Anna, S ;
Guerrera, D ;
Bonsignore, G .
CHEST, 2002, 122 (06) :1944-1948
[5]   Role of FEF25%-75% as a predictor of bronchial hyperreactivity in allergic patients [J].
Cirillo, Ignazio ;
Klersy, Catherine ;
Marseglia, Gian Luigi ;
Vizzaccaro, Andrea ;
Pallestrini, Eugenio ;
Tosca, Mariangela ;
Ciprandi, Giorgio .
ANNALS OF ALLERGY ASTHMA & IMMUNOLOGY, 2006, 96 (05) :692-700
[6]  
Crapo RO, 2000, AM J RESP CRIT CARE, V161, P309
[7]   Evaluation of asthma with hyperpolarized helium-3 MRI - Correlation with clinical severity and spirometry [J].
de lange, Eduard E. ;
Altes, Talissa A. ;
Patrie, James T. ;
Gaare, John D. ;
Knake, Jeffrey J. ;
Mugler, John P., III ;
Platts-Mills, Thomas A. .
CHEST, 2006, 130 (04) :1055-1062
[8]   Lung air spaces:: MR imaging evaluation with hyperpolarized 3He gas [J].
de Lange, EE ;
Mugler, JP ;
Brookeman, JR ;
Knight-Scott, J ;
Truwit, JD ;
Teates, CD ;
Daniel, TM ;
Bogorad, PL ;
Cates, GD .
RADIOLOGY, 1999, 210 (03) :851-857
[10]  
Edgington E.S., 1995, Randomization Tests, V3rd Edn