Journal article
Quantitative Assessment of Regional Dynamic Airway Collapse in Neonates via Retrospectively Respiratory-Gated H-1 Ultrashort Echo Time MRI
Journal of magnetic resonance imaging, Vol.49(3), pp.659-667
03/01/2019
DOI: 10.1002/jmri.26296
PMCID: PMC6375762
PMID: 30252988
Abstract
BackgroundNeonatal dynamic tracheal collapse (tracheomalacia, TM) is a common and serious comorbidity in infants, particularly those with chronic lung disease of prematurity (bronchopulmonary dysplasia, BPD) or congenital airway or lung-related conditions such as congenital diaphragmatic hernia (CDH), but the underlying pathology, impact on clinical outcomes, and response to therapy are not well understood. There is a pressing clinical need for an accurate, objective, and safe assessment of neonatal TM.
PurposeTo use retrospectively respiratory-gated ultrashort echo-time (UTE) MRI to noninvasively analyze moving tracheal anatomy for regional, quantitative evaluation of dynamic airway collapse in quiet-breathing, nonsedated neonates.
Study TypeProspective.
Population/SubjectsTwenty-seven neonatal subjects with varying respiratory morbidities (control, BPD, CDH, abnormal polysomnogram).
Field Strength/SequenceHigh-resolution 3D radial UTE MRI (0.7mm isotropic) on 1.5T scanner sited in the neonatal intensive care unit.
AssessmentImages were retrospectively respiratory-gated using the motion-modulated time-course of the k-space center. Tracheal surfaces were generated from segmentations of end-expiration/inspiration images and analyzed geometrically along the tracheal length to calculate percent-change in luminal cross-sectional area (A(%)) and ratio of minor-to-major diameters at end-expiration (r(D,exp)). Geometric results were compared to clinically available bronchoscopic findings (n=14).
Statistical TestsTwo-sample t-test.
ResultsMaximum A(%) significantly identified subjects with/without a bronchoscopic TM diagnosis (with: 46.910.0%; without: 27.05.8%; P < 0.001), as did minimum r(D,exp) (with: 0.3460.146; without: 0.6710.218; P=0.008). Subjects with severe BPD exhibited a far larger range of minimum r(D,exp) than subjects with mild/moderate BPD or controls (0.631 +/- 0.222, 0.782 +/- 0.075, and 0.776 +/- 0.030, respectively), while minimum r(D,exp) was reduced in CDH subjects (0.331 +/- 0.171) compared with controls (P < 0.001).
Data ConclusionRespiratory-gated UTE MRI can quantitatively and safely evaluate neonatal dynamic tracheal collapse, as validated with the clinical standard of bronchoscopy, without requiring invasive procedures, anesthesia, or ionizing radiation. Level of Evidence: 2 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2019;49:659-667.
Details
- Title: Subtitle
- Quantitative Assessment of Regional Dynamic Airway Collapse in Neonates via Retrospectively Respiratory-Gated H-1 Ultrashort Echo Time MRI
- Creators
- Alister J. Bates - Cincinnati Children's Hospital Medical CenterNara S. Higano - Cincinnati Children's Hospital Medical CenterErik B. Hysinger - University of CincinnatiRobert J. Fleck - Cincinnati Children's Hospital Medical CenterAndrew D. Hahn - University of Wisconsin–MadisonSean B. Fain - University of Wisconsin–MadisonPaul S. Kingma - Cincinnati Children's Hospital Medical CenterJason C. Woods - Cincinnati Children's Hospital Medical Center
- Resource Type
- Journal article
- Publication Details
- Journal of magnetic resonance imaging, Vol.49(3), pp.659-667
- DOI
- 10.1002/jmri.26296
- PMID
- 30252988
- PMCID
- PMC6375762
- NLM abbreviation
- J Magn Reson Imaging
- ISSN
- 1053-1807
- eISSN
- 1522-2586
- Publisher
- Wiley
- Number of pages
- 9
- Grant note
- P01 HD093363 / National Institutes of Health (NIH); United States Department of Health & Human Services; National Institutes of Health (NIH) - USA Research Innovation and Pilot Funding Program at Cincinnati Children's Hospital P01HD093363 / EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH & HUMAN DEVELOPMENT; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD) Perinatal Institute at Cincinnati Children's Hospital R01HL146689 / NATIONAL HEART, LUNG, AND BLOOD INSTITUTE; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI) Hartwell Foundation at University of Wisconsin-Madison
- Language
- English
- Date published
- 03/01/2019
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Radiology; Electrical and Computer Engineering; Health, Sport, and Human Physiology
- Record Identifier
- 9984275059502771
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