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- Title
Image Phenotyping of Preterm-Born Children Using Hyperpolarized <sup>129</sup>Xe Lung Magnetic Resonance Imaging and Multiple-Breath Washout.
- Authors
Ho-Fung Chan; Smith, Laurie J.; Biancardi, Alberto M.; Bray, Jody; Marshall, Helen; Hughes, Paul J. C.; Collier, Guilhem J.; Rao, Madhwesha; Norquay, Graham; Swift, Andrew J.; Hart, Kylie; Cousins, Michael; Watkins, W. John; Wild, Jim M.; Kotecha, Sailesh
- Abstract
Rationale: Preterm birth is associated with low lung function in childhood, but little is known about the lung microstructure in childhood. Objectives: We assessed the differential associations between the historical diagnosis of bronchopulmonary dysplasia (BPD) and current lung function phenotypes on lung ventilation and microstructure in preterm-born children using hyperpolarized 129Xe ventilation and diffusion-weighted magnetic resonance imaging (MRI) and multiple-breath washout (MBW). Methods: Data were available from 63 children (aged 9-13 yr), including 44 born preterm (<34 weeks' gestation) and 19 termborn control subjects (>37 weeks' gestation). Preterm-born children were classified, using spirometry, as prematurityassociated obstructive lung disease (POLD; FEV1, lower limit of normal [LLN] and FEV1/FVC,LLN), prematurity-associated preserved ratio of impaired spirometry (FEV1,LLN and FEV1/FVC>LLN), preterm-(FEV1>LLN) and term-born control subjects, and those with and without BPD. Ventilation heterogeneity metrics were derived from 129Xe ventilation MRI and SF6 MBW. Alveolar microstructural dimensions were derived from 129Xe diffusion-weighted MRI. Measurements and Main Results: 129Xe ventilation defect percentage and ventilation heterogeneity index were significantly increased in preterm-born children with POLD. In contrast, mean 129Xe apparent diffusion coefficient, 129Xe apparent diffusion coefficient interquartile range, and 129Xe mean alveolar dimension interquartile range were significantly increased in preterm-born children with BPD, suggesting changes of alveolar dimensions. MBW metrics were all significantly increased in the POLD group compared with preterm- and term-born control subjects. Linear regression confirmed the differential effects of obstructive disease on ventilation defects and BPD on lung microstructure. Conclusion: We show that ventilation abnormalities are associated with POLD, and BPD in infancy is associated with abnormal lung microstructure.
- Subjects
DIFFUSION magnetic resonance imaging; MAGNETIC resonance imaging; OBSTRUCTIVE lung diseases; BRONCHOPULMONARY dysplasia
- Publication
American Journal of Respiratory & Critical Care Medicine, 2023, Vol 207, Issue 1, p89
- ISSN
1073-449X
- Publication type
Article
- DOI
10.1164/rccm.202203-0606OC