Quantification of Pulmonary Perfusion with Free-Breathing Dynamic Contrast-Enhanced MRI – A Pilot Study in Healthy Volunteers

Abstract

Purpose: The assessment of pulmonary perfusion using dynamic contrast-enhanced (DCE) MRI is still limited in the clinical routine due to the necessity of breath holding. An acquisition technique for the quantitative assessment of pulmonary perfusion in free breathing was investigated in our study.

Materials and Methods: 10 healthy male volunteers underwent pulmonary DCE-MRI on a 1.5 T scanner. Each volunteer was examined twice: (a) in breath-hold half expiration and (b) during shallow free breathing. The pulmonary parenchyma was segmented automatically. The pulmonary plasma flow (PPF) and pulmonary plasma volume (PPV) were determined pixel-wise using a one-compartment model.

Results: All examinations were of diagnostic image quality. The measured mean values of the PPV were significantly lower in the breath-hold technique than during free breathing ((10.2 ± 2.8) ml/100 ml vs. (12.7 ± 3.9) ml/100 ml); p < 0.05). A significant difference was also observed between both PPF measurements (mean PPF (206.2 ± 104.0) ml/100 ml/min in breath-hold technique vs. (240.6 ± 114.0) ml/100 ml/min during free breathing; p < 0.05).

Conclusion: Free-breathing DCE-MRI appears to be suitable for the quantitative assessment of the pulmonary perfusion in healthy volunteers. The proposed segmentation and quantification approach does not suffer from the increased motion, as compared to the breath-holding measurement. The increased PPV and PPF during free breathing are in accordance with the results of previous studies concerning breathing influence on perfusion parameters. Overall, free-breathing DCE-MRI may be a promising technique for the assessment of pulmonary perfusion in various pathologies.

Citation Format:

• Maxien D, Ingrisch M, Meinel F et al. Quantification of Pulmonary Perfusion with Free-Breathing Dynamic Contrast-Enhanced MRI – A Pilot Study in Healthy Volunteers. Fortschr Röntgenstr 2013; 185: 1175 – 1181

Zusammenfassung

Ziel: Die Untersuchung der Lungenperfusion mittels dynamischer kontrastverstärkter MRT (DynKM-MRT) ist nur eingeschränkt in der klinischen Routine möglich, da die Untersuchung üblicherweise nur mit angehaltenem Atem erfolgt. In der aktuellen Studie wurde eine Akquisitionstechnik zur Bestimmung quantitativer Perfusionsparameter während freier Atmung untersucht.

Material und Methoden: 10 gesunde männliche Probanden wurden einer DynKM-MRT an einem 1,5 -T-Scanner unterzogen. Jeder Proband wurde zweimal untersucht; einmal mit der Vorgabe den Atem in halber Exspiration anzuhalten und einmal während flacher freier Atmung. Das Lungenparenchym wurde automatisch segmentiert. Der pulmonale Plasmafluss (PPF) und das pulmonale Plasmavolumen (PPV) wurden mit einem 1-Kompartiment-Modell pixelweise bestimmt.

Ergebnisse: Alle Untersuchungen waren von diagnostischer Bildqualität. Die gemessen durchschnittlichen Werte des PPV waren signifikant geringer in der Atemanhalttechnik als unter freier Atmung. ([10,2 ± 2,8] ml/100 ml vs. [12,7 ± 3,9] ml/100 ml); p < 0,05). Auch zwischen den beiden PPF-Messungen wurde ein signifikanter Unterschied beobachtet (durchschnittlicher PPF [206.2 ± 104.0] ml/100 ml/min beim Atemanhalt vs. [240.6 ± 114.0] ml/100 ml/min unter freier Atmung; p < 0,05).

Schlussfolgerung: Die Bestimmung von quantitativen Perfusionsparametern durch eine DynKM-MRT während freier Atmung in gesunden Probanden scheint möglich zu sein. Die vorgestellte Quantifizierungstechnik leidet im Vergleich zu den Messungen mit angehaltenem Atem nicht unter den verstärkten Atembewegungen. Das erhöhte PPV und der erhöhte PPF unter freier Atmung decken sich mit Ergebnissen aus vorherigen Studien über den Einfluss der Atemtiefe auf die Perfusionsparameter. Zusammenfassend könnte die DynKM-MRT unter freier Atmung eine vielversprechende Technik für die Bestimmung der Lungenperfusion bei einer Vielzahl von Krankheiten sein.

Key words

thorax - MR diffusion/perfusion - MR functional imaging - MR imaging

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