Characterizing Lung Parenchymal Aeration via Standardized Signal Intensity from Free-breathing 4D Dynamic MRI in Phantoms, Healthy Children, and Pediatric Patients with Thoracic Insufficiency Syndrome.

IF 3.8 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Radiology. Cardiothoracic imaging Pub Date : 2024-08-01 DOI:10.1148/ryct.230262
Yubing Tong, Jayaram K Udupa, Joseph M McDonough, Caiyun Wu, Lipeng Xie, Chamith S Rajapakse, Samantha Gogel, Sulagna Sarkar, Oscar H Mayer, Jason B Anari, Drew A Torigian, Patrick J Cahill
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Abstract

Purpose To investigate free-breathing thoracic bright-blood four-dimensional (4D) dynamic MRI (dMRI) to characterize aeration of parenchymal lung tissue in healthy children and patients with thoracic insufficiency syndrome (TIS). Materials and Methods All dMR images in patients with TIS were collected from July 2009 to June 2017. Standardized signal intensity (sSI) was investigated, first using a lung aeration phantom to establish feasibility and sensitivity and then in a retrospective research study of 40 healthy children (16 male, 24 female; mean age, 9.6 years ± 2.1 [SD]), 20 patients with TIS before and after surgery (11 male, nine female; mean age, 6.2 years ± 4.2), and another 10 healthy children who underwent repeated dMRI examinations (seven male, three female; mean age, 9 years ± 3.6). Individual lungs in 4D dMR images were segmented, and sSI was assessed for each lung at end expiration (EE), at end inspiration (EI), preoperatively, postoperatively, in comparison to normal lungs, and in repeated scans. Results Air content changes of approximately 6% were detectable in phantoms via sSI. sSI within phantoms significantly correlated with air occupation (Pearson correlation coefficient = -0.96 [P < .001]). For healthy children, right lung sSI was significantly lower than that of left lung sSI (at EE: 41 ± 6 vs 47 ± 6 and at EI: 39 ± 6 vs 43 ± 7, respectively; P < .001), lung sSI at EI was significantly lower than that at EE (P < .001), and left lung sSI at EE linearly decreased with age (r = -0.82). Lung sSI at EE and EI decreased after surgery for patients (although not statistically significantly, with P values of sSI before surgery vs sSI after surgery, left and right lung separately, in the range of 0.13-0.51). sSI varied within 1.6%-4.7% between repeated scans. Conclusion This study demonstrates the feasibility of detecting change in sSI in phantoms via bright-blood dMRI when air occupancy changes. The observed reduction in average lung sSI after surgery in pediatric patients with TIS may indicate postoperative improvement in parenchymal aeration. Keywords: MR Imaging, Thorax, Lung, Pediatrics, Thoracic Surgery, Lung Parenchymal Aeration, Free-breathing Dynamic MRI, MRI Intensity Standardization, Thoracic Insufficiency Syndrome Supplemental material is available for this article. © RSNA, 2024.

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通过模型、健康儿童和胸廓发育不全综合征儿科患者自由呼吸 4D 动态核磁共振成像的标准化信号强度描述肺实质通气情况。
目的 研究自由呼吸胸腔亮血四维(4D)动态磁共振成像(dMRI),以描述健康儿童和胸廓发育不全综合征(TIS)患者肺实质组织的通气情况。材料与方法 收集了 2009 年 7 月至 2017 年 6 月期间 TIS 患者的所有 dMR 图像。首先使用肺通气模型确定可行性和灵敏度,然后对 40 名健康儿童(16 名男性,24 名女性;平均年龄为 9.6 岁 ± 2.1 [SD])、20 名手术前后的 TIS 患者(11 名男性,9 名女性;平均年龄为 6.2 岁 ± 4.2)以及另外 10 名接受重复 dMRI 检查的健康儿童(7 名男性,3 名女性;平均年龄为 9 岁 ± 3.6)进行了标准化信号强度(sSI)调查。对 4D dMR 图像中的单个肺进行分割,并在呼气末 (EE)、吸气末 (EI)、术前、术后、与正常肺的比较以及重复扫描中对每个肺的 sSI 进行评估。结果 通过 sSI 在模型中可检测到约 6% 的空气含量变化。模型中的 sSI 与空气占位有显著相关性(皮尔逊相关系数 = -0.96 [P < .001])。对于健康儿童,右肺 sSI 明显低于左肺 sSI(EE:41 ± 6 vs 47 ± 6,EI:39 ± 6 vs 43 ± 7,P < .001),EI 的肺 sSI 明显低于 EE(P < .001),EE 的左肺 sSI 随年龄呈线性下降(r = -0.82)。患者手术后,EE 和 EI 处的肺 sSI 均有所下降(但无统计学意义,左肺和右肺手术前 sSI 与手术后 sSI 的 P 值分别在 0.13-0.51 之间)。结论 本研究证明了通过亮血 dMRI 在空气占用率发生变化时检测模型中 sSI 变化的可行性。所观察到的 TIS 儿童患者术后肺部平均 sSI 的减少可能表明术后肺实质通气情况有所改善。关键词磁共振成像,胸腔,肺,儿科,胸外科,肺实质通气,自由呼吸动态磁共振成像,磁共振成像强度标准化,胸廓供血不足综合征 本文有补充材料。© RSNA, 2024.
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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