Journal article
Neonatal Pulmonary Magnetic Resonance Imaging of Bronchopulmonary Dysplasia Predicts Short-Term Clinical Outcomes
American journal of respiratory and critical care medicine, Vol.198(10), pp.1302-1311
11/15/2018
DOI: 10.1164/rccm.201711-2287OC
PMCID: PMC6290936
PMID: 29790784
Abstract
Bronchopulmonary dysplasia (BPD) is a serious neonatal pulmonary condition associated with premature birth, but the underlying parenchymal disease and trajectory are poorly characterized. The current National Institute of Child Health and Human Development (NICHD)/NHLBI definition of BPD severity is based on degree of prematurity and extent of oxygen requirement. However, no clear link exists between initial diagnosis and clinical outcomes.
We hypothesized that magnetic resonance imaging (MRI) of structural parenchymal abnormalities will correlate with NICHD-defined BPD disease severity and predict short-term respiratory outcomes.
A total of 42 neonates (20 severe BPD, 6 moderate, 7 mild, 9 non-BPD control subjects; 40 ± 3-wk postmenstrual age) underwent quiet-breathing structural pulmonary MRI (ultrashort echo time and gradient echo) in a neonatal ICU-sited, neonatal-sized 1.5 T scanner, without sedation or respiratory support unless already clinically prescribed. Disease severity was scored independently by two radiologists. Mean scores were compared with clinical severity and short-term respiratory outcomes. Outcomes were predicted using univariate and multivariable models, including clinical data and scores.
MRI scores significantly correlated with severities and predicted respiratory support at neonatal ICU discharge (P < 0.0001). In multivariable models, MRI scores were by far the strongest predictor of respiratory support duration over clinical data, including birth weight and gestational age. Notably, NICHD severity level was not predictive of discharge support.
Quiet-breathing neonatal pulmonary MRI can independently assess structural abnormalities of BPD, describe disease severity, and predict short-term outcomes more accurately than any individual standard clinical measure. Importantly, this nonionizing technique can be implemented to phenotype disease, and has potential to serially assess efficacy of individualized therapies.
Details
- Title: Subtitle
- Neonatal Pulmonary Magnetic Resonance Imaging of Bronchopulmonary Dysplasia Predicts Short-Term Clinical Outcomes
- Creators
- Nara S Higano - 1 Center for Pulmonary Imaging Research, Division of Pulmonary Medicine and Department of Radiology.David R Spielberg - 1 Center for Pulmonary Imaging Research, Division of Pulmonary Medicine and Department of Radiology.Robert J Fleck - 2 Department of Radiology, and.Andrew H Schapiro - 2 Department of Radiology, and.Laura L Walkup - 1 Center for Pulmonary Imaging Research, Division of Pulmonary Medicine and Department of Radiology.Andrew D Hahn - University of Wisconsin–MadisonJean A Tkach - 2 Department of Radiology, and.Paul S Kingma - Cincinnati Children's Hospital Medical CenterStephanie L Merhar - Cincinnati Children's Hospital Medical CenterSean B Fain - University of Wisconsin–MadisonJason C Woods - 1 Center for Pulmonary Imaging Research, Division of Pulmonary Medicine and Department of Radiology.
- Resource Type
- Journal article
- Publication Details
- American journal of respiratory and critical care medicine, Vol.198(10), pp.1302-1311
- DOI
- 10.1164/rccm.201711-2287OC
- PMID
- 29790784
- PMCID
- PMC6290936
- NLM abbreviation
- Am J Respir Crit Care Med
- ISSN
- 1073-449X
- eISSN
- 1535-4970
- Grant note
- T32 HL007752 / NHLBI NIH HHS P01 HL070831 / NHLBI NIH HHS T32 CA009206 / NCI NIH HHS K12 HL119986 / NHLBI NIH HHS UL1 TR001425 / NCATS NIH HHS
- Language
- English
- Date published
- 11/15/2018
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Radiology; Electrical and Computer Engineering; Health, Sport, and Human Physiology
- Record Identifier
- 9984274956302771
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