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Diverse cardiopulmonary diseases are associated with distinct xenon magnetic resonance imaging signatures.

Publication ,  Journal Article
Wang, Z; Bier, EA; Swaminathan, A; Parikh, K; Nouls, J; He, M; Mammarappallil, JG; Luo, S; Driehuys, B; Rajagopal, S
Published in: Eur Respir J
December 2019

BACKGROUND: As an increasing number of patients exhibit concomitant cardiac and pulmonary disease, limitations of standard diagnostic criteria are more frequently encountered. Here, we apply noninvasive 129Xe magnetic resonance imaging (MRI) and spectroscopy to identify patterns of regional gas transfer impairment and haemodynamics that are uniquely associated with chronic obstructive pulmonary disease (COPD), idiopathic pulmonary fibrosis (IPF), left heart failure (LHF) and pulmonary arterial hypertension (PAH). METHODS: Healthy volunteers (n=23) and patients with COPD (n=8), IPF (n=12), LHF (n=6) and PAH (n=10) underwent 129Xe gas transfer imaging and dynamic spectroscopy. For each patient, three-dimensional maps were generated to depict ventilation, barrier uptake (129Xe dissolved in interstitial tissue) and red blood cell (RBC) transfer (129Xe dissolved in RBCs). Dynamic 129Xe spectroscopy was used to quantify cardiogenic oscillations in the RBC signal amplitude and frequency shift. RESULTS: Compared with healthy volunteers, all patient groups exhibited decreased ventilation and RBC transfer (both p≤0.01). Patients with COPD demonstrated more ventilation and barrier defects compared with all other groups (both p≤0.02). In contrast, IPF patients demonstrated elevated barrier uptake compared with all other groups (p≤0.007), and increased RBC amplitude and shift oscillations compared with healthy volunteers (p=0.007 and p≤0.01, respectively). Patients with COPD and PAH both exhibited decreased RBC amplitude oscillations (p=0.02 and p=0.005, respectively) compared with healthy volunteers. LHF was distinguishable from PAH by enhanced RBC amplitude oscillations (p=0.01). CONCLUSION: COPD, IPF, LHF and PAH each exhibit unique 129Xe MRI and dynamic spectroscopy signatures. These metrics may help with diagnostic challenges in cardiopulmonary disease and increase understanding of regional lung function and haemodynamics at the alveolar-capillary level.

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Published In

Eur Respir J

DOI

EISSN

1399-3003

Publication Date

December 2019

Volume

54

Issue

6

Location

England

Related Subject Headings

  • Young Adult
  • Xenon Isotopes
  • Respiratory System
  • Pulmonary Disease, Chronic Obstructive
  • Pulmonary Arterial Hypertension
  • Middle Aged
  • Male
  • Magnetic Resonance Imaging
  • Imaging, Three-Dimensional
  • Idiopathic Pulmonary Fibrosis
 

Citation

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Wang, Z., Bier, E. A., Swaminathan, A., Parikh, K., Nouls, J., He, M., … Rajagopal, S. (2019). Diverse cardiopulmonary diseases are associated with distinct xenon magnetic resonance imaging signatures. Eur Respir J, 54(6). https://doi.org/10.1183/13993003.00831-2019
Wang, Ziyi, Elianna A. Bier, Aparna Swaminathan, Kishan Parikh, John Nouls, Mu He, Joseph G. Mammarappallil, Sheng Luo, Bastiaan Driehuys, and Sudarshan Rajagopal. “Diverse cardiopulmonary diseases are associated with distinct xenon magnetic resonance imaging signatures.Eur Respir J 54, no. 6 (December 2019). https://doi.org/10.1183/13993003.00831-2019.
Wang Z, Bier EA, Swaminathan A, Parikh K, Nouls J, He M, et al. Diverse cardiopulmonary diseases are associated with distinct xenon magnetic resonance imaging signatures. Eur Respir J. 2019 Dec;54(6).
Wang, Ziyi, et al. “Diverse cardiopulmonary diseases are associated with distinct xenon magnetic resonance imaging signatures.Eur Respir J, vol. 54, no. 6, Dec. 2019. Pubmed, doi:10.1183/13993003.00831-2019.
Wang Z, Bier EA, Swaminathan A, Parikh K, Nouls J, He M, Mammarappallil JG, Luo S, Driehuys B, Rajagopal S. Diverse cardiopulmonary diseases are associated with distinct xenon magnetic resonance imaging signatures. Eur Respir J. 2019 Dec;54(6).
Journal cover image

Published In

Eur Respir J

DOI

EISSN

1399-3003

Publication Date

December 2019

Volume

54

Issue

6

Location

England

Related Subject Headings

  • Young Adult
  • Xenon Isotopes
  • Respiratory System
  • Pulmonary Disease, Chronic Obstructive
  • Pulmonary Arterial Hypertension
  • Middle Aged
  • Male
  • Magnetic Resonance Imaging
  • Imaging, Three-Dimensional
  • Idiopathic Pulmonary Fibrosis