Image Phenotyping of Preterm-Born Children Using Hyperpolarized 129Xe Lung Magnetic Resonance Imaging and Multiple-Breath Washout
Year: 2022
Type: article
Study design: Observational Study
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 term-born control subjects (≥37 weeks’ gestation). Preterm-born children were classified, using spirometry, as prematurity-associated 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.
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
Awards: POLARIS: Pulmonary, Lung and Respiratory Imaging Sheffield (Joint funding with MRC), Stratification and phenotyping of pulmonary vascular disease with imaging, Expansion of state-of-the-art MR imaging infrastructure for pulmonary disease stratification: POLARIS, Hyperpolarised gas MRI and multiple breath inert gas washout to improve management and understanding of cystic fibrosis lung disease, Translating novel pulmonary MR imaging methods in to clinical practice, G4081864388, G4115593199, Stratification and phenotyping of pulmonary vascular disease with imaging, RHiNO: Respiratory Health In Preterm Neonatal Outcomes
OpenAlex ID: W4291997262