Journal article
Mucus Plugs in Asthma at CT Associated with Regional Ventilation Defects at He-3 MRI
Radiology, Vol.303(1), pp.184-190
04/01/2022
DOI: 10.1148/radiol.2021204616
PMCID: PMC8962781
PMID: 34931858
Abstract
Background: Airway mucus plugs in asthma are associated with exacerbation frequency, increased eosinophilia, and reduced lung function. The relationship between mucus plugs and spatially overlapping ventilation abnormalities observed at hyperpolarized gas MRI has not been assessed quantitatively.
Purpose: To assess regional associations between CT mucus plugs scored by individual bronchopulmonary segment and corresponding measurements of segmental ventilation defect percentage (VDP) at hyperpolarized helium 3 (3He) MRI.
Materials and Methods: In this secondary analysis of a Health Insurance Portability and Accountability Act-compliant prospective observational cohort, participants in the Severe Asthma Research Program (SARP) III (NCT01760915) between December 2012 and August 2015 underwent hyperpolarized 3He MRI to determine segmental VDP. Segmental mucus plugs at CT were scored by two readers, with segments scored as plugged only if both readers agreed independently. A linear mixed-effects model controlling for interpatient variability was then used to assess differences in VDP in plugged versus plug-free segments.
Results: Forty-four participants with asthma were assessed (mean age 6 standard deviation, 47 years 6 15; 29 women): 19 with mild-to-moderate asthma and 25 with severe asthma. Mucus plugs were observed in 49 total bronchopulmonary segments across eight of 44 patients. Segments containing mucus plugs had a median segmental VDP of 25.9% (25th-75th percentile, 7.3%-38.3%) versus 1.4% (25th-75th percentile, 0.1%-5.2%; P <=.001) in plug-free segments. Similarly, the model estimated a segmental VDP of 18.9% (95% CI: 15.7, 22.2) for mucus-plugged segments versus 5.1% (95% CI: 3.3, 7.0) for plug-free segments (P <=.001). Participants with one or more mucus plugs had a median whole-lung VDP of 11.1% (25th-75th percentile, 7.1%-18.9%) versus 3.1% (25th-75th percentile, 1.1%-4.4%) in those without plugs (P <=.001).
Conclusion: Airway mucus plugging at CT was associated with reduced ventilation in the same bronchopulmonary segment at -hyperpolarized helium 3 MRI, suggesting that mucus plugging may be an important cause of ventilation defects in asthma. (C) RSNA, 2021
Details
- Title: Subtitle
- Mucus Plugs in Asthma at CT Associated with Regional Ventilation Defects at He-3 MRI
- Creators
- David G. Mummy - Duke UniversityEleanor M. Dunican - University College DublinKatherine J. Carey - University of IowaMichael D. Evans - University of Wisconsin–MadisonBrett M. Elicker - From the Center for In Vivo Microscopy and Department of Radiology, Duke University, Durham, NC (D.G.M.); School of Medicine, University College Dublin, Dublin, Ireland (E.M.D.); Departments of Medical Physics (K.J.C., S.K.N., S.B.F.), Biostatistics and Medical Informatics (M.D.E.), Radiology (S.K.N., M.L.S., S.B.F.), Pharmacy (R.L.S.), Pediatrics (S.K.N., R.L.S.), and Allergy, Pulmonary & Critical Care Medicine (R.L.S., N.N.J., L.C.D.), Wisconsin Institutes for Medical Research, University of Wisconsin-Madison, 1111 Highland Ave, Room 2488, Madison, WI 53705; Department of Radiology (B.M.E.) and School of Medicine (J.V.F.), University of California-San Francisco, San Francisco, Calif; Department of Radiology, University of Iowa, Iowa City, Iowa (J.D.N., S.B.F.); and Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (D.S.G.).John D Jr Newell - Univ Iowa, Dept Radiol, Iowa City, IA 52242 USADavid S. Gierada - Washington University in St. LouisScott K. Nagle - University of IowaMark L. Schiebler - University of IowaRonald L. Sorkness - University of IowaNizar N. Jarjour - University of IowaLoren C. Denlinger - University of IowaJohn Fahy - University of IowaSean B. Fain - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Radiology, Vol.303(1), pp.184-190
- Publisher
- RADIOLOGICAL SOC NORTH AMERICA (RSNA)
- DOI
- 10.1148/radiol.2021204616
- PMID
- 34931858
- PMCID
- PMC8962781
- ISSN
- 0033-8419
- eISSN
- 1527-1315
- Number of pages
- 7
- Grant note
- S10 OD016394 / NIH/National Center for Advancing Translational Sciences (NCATS); United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Center for Advancing Translational Sciences (NCATS) Wisconsin Alumni Research Foundation (WARF) - Technology Transfer Research Assistantship R01 HL080412; U10 HL109168 / Severe Asthma Research Program (SARP), National Institutes of Health (NIH)/National Heart, Lung, and Blood Institute (NHLBI)
- Language
- English
- Date published
- 04/01/2022
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Radiology; Electrical and Computer Engineering; Health and Human Physiology
- Record Identifier
- 9984275053702771
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