Journal article
Quantitative Magnetic Resonance Imaging of Bronchopulmonary Dysplasia in the Neonatal Intensive Care Unit Environment
American journal of respiratory and critical care medicine, Vol.192(10), pp.1215-1222
11/15/2015
DOI: 10.1164/rccm.201503-0552OC
PMCID: PMC4731620
PMID: 26186608
Abstract
Bronchopulmonary dysplasia (BPD) is a prevalent yet poorly characterized pulmonary complication of premature birth; the current definition is based solely on oxygen dependence at 36 weeks postmenstrual age without objective measurements of structural abnormalities across disease severity.
We hypothesize that magnetic resonance imaging (MRI) can spatially resolve and quantify the structural abnormalities of the neonatal lung parenchyma associated with premature birth.
Using a unique, small-footprint, 1.5-T MRI scanner within our neonatal intensive care unit (NICU), diagnostic-quality MRIs using commercially available sequences (gradient echo and spin echo) were acquired during quiet breathing in six patients with BPD, six premature patients without diagnosed BPD, and six full-term NICU patients (gestational ages, 23-39 wk) at near term-equivalent age, without administration of sedation or intravenous contrast. Images were scored by a radiologist using a modified Ochiai score, and volumes of high- and low-signal intensity lung parenchyma were quantified by segmentation and threshold analysis.
Signal increases, putatively combinations of fibrosis, edema, and atelectasis, were present in all premature infants. Infants with diagnosed BPD had significantly greater volume of high-signal lung (mean ± SD, 26.1 ± 13.8%) compared with full-term infants (7.3 ± 8.2%; P = 0.020) and premature infants without BPD (8.2 ± 6.4%; P = 0.026). Signal decreases, presumably alveolar simplification, only appeared in the most severe BPD cases, although cystic appearance did increase with severity.
Pulmonary MRI reveals quantifiable, significant differences between patients with BPD, premature patients without BPD, and full-term control subjects. These methods could be implemented to individually phenotype disease, which may impact clinical care and predict future outcomes.
Details
- Title: Subtitle
- Quantitative Magnetic Resonance Imaging of Bronchopulmonary Dysplasia in the Neonatal Intensive Care Unit Environment
- Creators
- Laura L Walkup - 1 Center for Pulmonary Imaging Research, Division of Pulmonary Medicine, Department of Radiology.Jean A Tkach - 2 Imaging Research Center, Department of Radiology.Nara S Higano - Washington University in St. LouisRobert P Thomen - Washington University in St. LouisSean B Fain - University of Wisconsin–MadisonStephanie L Merhar - 5 Division of Neonatology and Pulmonary Biology.Robert J Fleck - 6 Department of Radiology, and.Raouf S Amin - Cincinnati Children's Hospital Medical CenterJason C Woods - Washington University in St. Louis
- Resource Type
- Journal article
- Publication Details
- American journal of respiratory and critical care medicine, Vol.192(10), pp.1215-1222
- DOI
- 10.1164/rccm.201503-0552OC
- PMID
- 26186608
- PMCID
- PMC4731620
- NLM abbreviation
- Am J Respir Crit Care Med
- ISSN
- 1073-449X
- eISSN
- 1535-4970
- Grant note
- T32 HL007752 / NHLBI NIH HHS UL1 TR001425 / NCATS NIH HHS
- Language
- English
- Date published
- 11/15/2015
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Radiology; Electrical and Computer Engineering; Health, Sport, and Human Physiology
- Record Identifier
- 9984274957502771
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