Quantitative and O<sub>2</sub> Enhanced MRI of the Pathologic Lung: Findings in Emphysema, Fibrosis, and Cystic Fibrosis

Stadler, Alfred; Stiebellehner, Leopold; Jakob, Peter M.; Arnold, Johannes F. T.; Eisenhuber, Edith; von Katzler, Isabella; Bankier, Alexander A.

doi:https://doi.org/10.1155/2007/23624

International Journal of Biomedical Imaging

On this page

Abstract References Copyright Related Articles

Special Issue

Multimodal Imaging and Hybrid Scanners

View this Special Issue

Research Article | Open Access

Volume 2007 | Article ID 023624 | https://doi.org/10.1155/2007/23624

Quantitative and O₂ Enhanced MRI of the Pathologic Lung: Findings in Emphysema, Fibrosis, and Cystic Fibrosis

Alfred Stadler,¹Leopold Stiebellehner,²Peter M. Jakob,³Johannes F. T. Arnold,³Edith Eisenhuber,⁴Isabella von Katzler,¹and Alexander A. Bankier¹

Academic Editor: Haim Azhari

Received23 Nov 2006

Accepted25 Feb 2007

Published22 Apr 2007

Abstract

Purpose: beyond the pure morphological visual representation, MR imaging offers the possibility to quantify parameters in the healthy, as well as, in pathologic lung parenchyma. Gas exchange is the primary function of the lung and the transport of oxygen plays a key role in pulmonary physiology and pathophysiology. The purpose of this review is to present a short overview of the relaxation mechanisms of the lung and the current technical concepts of T1 mapping and methods of oxygen enhanced MR imaging. Material and Methods: molecular oxygen has weak paramagnetic properties so that an increase in oxygen concentration results in shortening of the T1 relaxation time and thus to an increase of the signal intensity in T1 weighted images. A possible way to gain deeper insights into the relaxation mechanisms of the lung is the calculation of parameter Maps. T1 Maps based on a snapshot FLASH sequence obtained during the inhalation of various oxygen concentrations provide data for the creation of the so-called oxygen transfer function (OTF), assigning a measurement for local oxygen transfer. T1 weighted single shot TSE sequences also permit expression of the signal changing effects associated with the inhalation of pure oxygen. Results: the average of the mean T1 values over the entire lung in inspiration amounts to 1199 +/− 117 milliseconds, the average of the mean T1 values in expiration was 1333 +/− 167 milliseconds. T1 Maps of patients with emphysema and lung fibrosis show fundamentally different behavior patterns. Oxygen enhanced MRT is able to demonstrate reduced diffusion capacity and diminished oxygen transport in patients with emphysema and cystic fibrosis. Discussion: results published in literature indicate that T1 mapping and oxygen enhanced MR imaging are promising new methods in functional imaging of the lung and when evaluated in conjunction with the pure morphological images can provide additional valuable information.

References

P. A. Bottomley, C. J. Hardy, R. E. Argersinger, and G. Allen-Moore, “A review of ${}^{1}H$ nuclear magnetic resonance relaxation in pathology: are $T_{1}$ and $T_{2}$ diagnostic?” Medical Physics, vol. 14, no. 1, pp. 1–37, 1987.
View at: Publisher Site | Google Scholar
C. E. Hayes, T. A. Case, D. C. Ailion et al., “Lung water quantitation by nuclear magnetic resonance imaging,” Science, vol. 216, no. 4552, pp. 1313–1315, 1982.
View at: Publisher Site | Google Scholar
A. G. Cutillo, A. H. Morris, D. C. Ailion, C. H. Durney, and K. Ganesan, “Quantitative assessment of pulmonary edema by nuclear magnetic resonance methods,” Journal of Thoracic Imaging, vol. 3, no. 3, pp. 51–58, 1988.
View at: Publisher Site | Google Scholar
P. W. Johnston, F. M. MacLennan, J. G. Simpson, and F. W. Smith, “Nuclear magnetic resonance imaging of pulmonary infarction and oedema in excised cadaver lungs,” Magnetic Resonance Imaging, vol. 3, no. 2, pp. 157–161, 1985.
View at: Publisher Site | Google Scholar
M. Kveder, I. Zupancic, G. Lahajnar et al., “Water proton NMR relaxation mechanisms in lung tissue,” Magnetic Resonance in Medicine, vol. 7, no. 4, pp. 432–441, 1988.
View at: Publisher Site | Google Scholar
C. R. Taylor, H. D. Sostman, J. C. Gore, and G. Walker Smith, “Proton relaxation times in bleomycin-induced lung injury,” Investigative Radiology, vol. 22, no. 8, pp. 621–626, 1987.
View at: Publisher Site | Google Scholar
S. Vinitski, M. G. Pearson, S. J. Karlik et al., “Differentiation of parenchymal lung disorders with in vitro proton nuclear magnetic resonance,” Magnetic Resonance in Medicine, vol. 3, no. 1, pp. 120–125, 1986.
View at: Publisher Site | Google Scholar
S. Vinitski, R. M. Steiner, H. R. Wexler, and M. Rifkin, “Assessment of lung water by magnetic resonance in three types of pulmonary edema,” Heart and Vessels, vol. 4, no. 2, pp. 88–93, 1988.
View at: Publisher Site | Google Scholar
T. D. Scholz, S. R. Fleagle, T. L. Burns, and D. J. Skorton, “Tissue determinants of nuclear magnetic resonance relaxation times. Effect of water and collagen content in muscle and tendon,” Investigative Radiology, vol. 24, no. 11, pp. 893–898, 1989.
View at: Publisher Site | Google Scholar
A. Stadler, P. M. Jakob, M. Griswold, M. Barth, and A. A. Bankier, “T1 mapping of the entire lung parenchyma: influence of the respiratory phase in healthy individuals,” Journal of Magnetic Resonance Imaging, vol. 21, no. 6, pp. 759–764, 2005.
View at: Publisher Site | Google Scholar
I. R. Young, G. J. Clarke, D. R. Bailes, J. M. Pennock, F. H. Doyle, and G. M. Bydder, “Enhancement of relaxation rate with paramagnetic contrast agents in NMR imaging,” Journal of Computed Tomography, vol. 5, no. 6, pp. 543–547, 1981.
View at: Publisher Site | Google Scholar
R. F. Lodato, “Oxygen toxicity,” Critical Care Clinics, vol. 6, no. 3, pp. 749–765, 1990.
View at: Google Scholar
R. A. Brooks and G. Di Chiro, “Magnetic resonance imaging of stationary blood: a review,” Medical Physics, vol. 14, no. 6, pp. 903–913, 1987.
View at: Publisher Site | Google Scholar
R. R. Edelman, H. Hatabu, E. Tadamura, W. Li, and P. V. Prasad, “Noninvasive assessment of regional ventilation in the human lung using oxygen-enhanced magnetic resonance imaging,” Nature Medicine, vol. 2, no. 11, pp. 1236–1239, 1996.
View at: Publisher Site | Google Scholar
E. Tadamura, H. Hatabu, W. Li, P. V. Prasad, and R. R. Edelman, “Effect of oxygen inhalation on relaxation times in various tissues,” Journal of Magnetic Resonance Imaging, vol. 7, no. 1, pp. 220–225, 1997.
View at: Google Scholar
Y. Ohno, Q. Chen, and H. Hatabu, “Oxygen-enhanced magnetic resonance ventilation imaging of lung,” European Journal of Radiology, vol. 37, no. 3, pp. 164–171, 2001.
View at: Publisher Site | Google Scholar
Q. Chen, P. M. Jakob, M. A. Griswold, D. L. Levin, H. Hatabu, and R. R. Edelman, “Oxygen enhanced MR ventilation imaging of the lung,” Magnetic Resonance Materials in Physics, Biology and Medicine, vol. 7, no. 3, pp. 153–161, 1998.
View at: Publisher Site | Google Scholar
Y. Ohno, H. Hatabu, D. Takenaka, M. van Cauteren, M. Fujii, and K. Sugimura, “Dynamic oxygen-enhanced MRI reflects diffusing capacity of the lung,” Magnetic Resonance in Medicine, vol. 47, no. 6, pp. 1139–1144, 2002.
View at: Publisher Site | Google Scholar
C. J. Müller, M. Schwaiblmair, J. Scheidler et al., “Pulmonary diffusing capacity: assessment with oxygen-enhanced lung MR imaging-preliminary findings,” Radiology, vol. 222, no. 2, pp. 499–506, 2002.
View at: Google Scholar
P. M. Jakob, T. Wang, G. Schultz, H. Hebestreit, A. Hebestreit, and D. Hahn, “Assessment of human pulmonary function using oxygen-enhanced $T_{1}$ imaging in patients with cystic fibrosis,” Magnetic Resonance in Medicine, vol. 51, no. 5, pp. 1009–1016, 2004.
View at: Publisher Site | Google Scholar
C. J. Bergin, G. H. Glover, and J. M. Pauly, “Lung parenchyma: magnetic susceptibility in MR imaging,” Radiology, vol. 180, no. 3, pp. 845–848, 1991.
View at: Google Scholar
H. Hatabu, D. C. Alsop, J. Listerud, M. Bonnet, and W. B. Gefter, “ $T 2^{*}$ and proton density measurement of normal human lung parenchyma using submillisecond echo time gradient echo magnetic resonance imaging,” European Journal of Radiology, vol. 29, no. 3, pp. 245–252, 1999.
View at: Publisher Site | Google Scholar
K. W. Stock, Q. Chen, H. Hatabu, and R. R. Edelman, “Magnetic resonance $T 2^{*}$ measurements of the normal human lung in vivo with ultra-short echo times,” Magnetic Resonance Imaging, vol. 17, no. 7, pp. 997–1000, 1999.
View at: Publisher Site | Google Scholar
H. Hatabu, J. Gaa, E. Tadamura et al., “MR imaging of pulmonary parenchyma with a half-Fourier single-shot turbo spin-echo (HASTE) sequence,” European Journal of Radiology, vol. 29, no. 2, pp. 152–159, 1999.
View at: Publisher Site | Google Scholar
Y. Ohno, H. Hatabu, D. Takenaka, S. Adachi, M. van Cauteren, and K. Sugimura, “Oxygen-enhanced MR ventilation imaging of the lung: preliminary clinical experience in 25 subjects,” American Journal of Roentgenology, vol. 177, no. 1, pp. 185–194, 2001.
View at: Google Scholar
P. M. Jakob, C. M. Hillenbrand, T. Wang, G. Schultz, D. Hahn, and A. Haase, “Rapid quantitative lung ${}^{1}H$ $T_{1}$ mapping,” Journal of Magnetic Resonance Imaging, vol. 14, no. 6, pp. 795–799, 2001.
View at: Publisher Site | Google Scholar
R. Löffler, C. J. Müller, M. Peller et al., “Optimization and evaluation of the signal intensity change in multisection oxygen-enhanced MR lung imaging,” Magnetic Resonance in Medicine, vol. 43, no. 6, pp. 860–866, 2000.
View at: Google Scholar
A. Haase, D. Matthaei, R. Bartkowski, E. Duhmke, and D. Leibfritz, “Inversion recovery snapshot FLASH MR imaging,” Journal of Computer Assisted Tomography, vol. 13, no. 6, pp. 1036–1040, 1989.
View at: Publisher Site | Google Scholar
G. Snider, J. Kleinermann, and W. Thurlbeck, “The definition of emphysema. Report of a National Heart, Lung, and Blood Institute, Division of Lung Diseases workshop,” American Review of Respiratory Disease, vol. 132, no. 1, pp. 182–185, 1985.
View at: Google Scholar
A. Madani, C. Keyzer, and P. A. Gevenois, “Quantitative computed tomography assessment of lung structure and function in pulmonary emphysema,” European Respiratory Journal, vol. 18, no. 4, pp. 720–730, 2001.
View at: Publisher Site | Google Scholar
J. A. Pierce, J. B. Hocott, and R. V. Ebert, “The collagen and elastin content of the lung in emphysema,” Annals of Internal Medicine, vol. 55, pp. 210–222, 1961.
View at: Google Scholar
A. Stadler, L. Stiebellehner, P. M. Jakob, M. Griswold, and A. A. Bankier, “T1 mapping of the entire lung in patients with emphysema and fibrosis compared to normal individuals,” in Proceedings of the 91st Radiological Society of North America Conference (RSNA '05), p. 242, Chicago, Ill, USA, November-December 2005, Book of Abstracts.
View at: Google Scholar

Copyright

Copyright © 2007 Alfred Stadler et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

PDF Download Citation Order printed copies

Views

374

Downloads

1044

Citations