Journal article
Improving Pulmonary Perfusion Assessment by Dynamic Contrast-Enhanced Computed Tomography in an Experimental Lung Injury Model
Journal of applied physiology (1985), Vol.134(6), pp.1496-1507
06/2023
DOI: 10.1152/japplphysiol.00159.2023
PMCID: PMC10228674
PMID: 37167261
Abstract
Introduction: Pulmonary perfusion has been poorly characterized in acute respiratory distress syndrome(ARDS). Optimizing protocols to measure pulmonary blood flow(PBF) via dynamic contrast-enhanced(DCE) computed tomography(CT) could improve understanding of how ARDS alters pulmonary perfusion. In this study, comparative evaluations of injection protocols and tracer-kinetic analysis models were performed based on DCE-CT data measured in ventilated pigs with and without lung injury. Materials and Methods: 10 Yorkshire pigs were anesthetized, intubated, and mechanically ventilated; lung injury was induced by bronchial hydrochloric acid instillation. Each DCE-CT scan was obtained during 30-second end-expiratory breath-hold. Reproducibility of PBF measurements was evaluated in 3 pigs. In 8 pigs, undiluted and diluted Isovue-370 were separately injected to evaluate the effect of contrast viscosity on estimated PBF values. PBF was estimated with the peak-enhancement and the steepest-slope approach. Total-lung PBF was estimated in 2 healthy pigs to compare with cardiac output measured invasively by thermodilution in the pulmonary artery. Results: Repeated measurements in the same animals yielded a good reproducibility of computed PBF maps. Injecting diluted isovue-370 resulted in smaller contrast-time curves in the pulmonary artery(p<0.01) and vein(p<0.01) without substantially diminishing peak signal intensity(p=0.46 in the pulmonary artery) compared to the pure contrast agent since its viscosity is closer to that of blood. As compared to the peak-enhancement model, PBF values estimated by the steepest-slope model with diluted contrast were much closer to the cardiac output(R2=0.82) as compared to the peak-enhancement model. Conclusion: DCE-CT using the steepest-slope model and diluted contrast agent provided reliable quantitative estimates of PBF.
Details
- Title: Subtitle
- Improving Pulmonary Perfusion Assessment by Dynamic Contrast-Enhanced Computed Tomography in an Experimental Lung Injury Model
- Creators
- Yi Xin - Harvard Medical SchoolTaehwan Kim - Massachusetts General HospitalTilo Winkler - Harvard Medical SchoolGunnar Brix - Department of Medical and Occupational Radiation Protection, Federal Office for Radiation Protection, GermanyTimothy Gaulton - Harvard Medical SchoolSarah E Gerard - University of IowaJacob Herrmann - University of IowaKevin T Martin - Massachusetts General HospitalMarcus Victor - Electronics Engineering Division, Aeronautics Institute of Technology, Sao Paulo, BrazilKristan Reutlinger - University of PennsylvaniaMarcelo Amato - Hospital das Clínicas da Faculdade de Medicina da Universidade de São PauloLorenzo Berra - Harvard Medical SchoolMannudeep K Kalra - Harvard Medical SchoolMaurizio Cereda - Harvard Medical School
- Resource Type
- Journal article
- Publication Details
- Journal of applied physiology (1985), Vol.134(6), pp.1496-1507
- DOI
- 10.1152/japplphysiol.00159.2023
- PMID
- 37167261
- PMCID
- PMC10228674
- NLM abbreviation
- J Appl Physiol Respir Environ Exerc Physiol
- ISSN
- 0161-7567
- eISSN
- 1522-1601
- Grant note
- R01-HL137389 / HHS | NIH | National Heart, Lung, and Blood Institute (NHLBI)
- Language
- English
- Electronic publication date
- 05/11/2023
- Date published
- 06/2023
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Anesthesia
- Record Identifier
- 9984406604602771
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