患有哮喘的异卵双胞胎：气道CT和MRI通气异常的空间匹配
2020/01/07
摘要
近期，肺功能磁共振成像发现哮喘患者在空间和时间上存在持续的通气异常，这与之前电脑模拟的哮喘模型中患者的通气缺陷可能是随机分布的形成对比。在一项使用肺部MRI、CT成像和肺功能测试的病例研究中，我们在7年的前瞻性评估过程中，异卵的成年女性双胞胎，每个人都有终身的哮喘病史。我们在基线和随访7年后评估肺功能和MRI通气的异质性。在所有的双胞胎中， MRI通气缺陷和左侧上叶亚节段性异常气道存在空间上的一致性，且在7年后仍维持在相同的空间位置。如果通风缺陷是随机分布的，其概率约为每13万人中有1人。我们对相关哮喘患者的MRI观察提示，哮喘患者的通气异常可能不是随机分布的，而是长期存在于远端气道异常。
Abstract
Recent pulmonary functional MRI findings of spatially and temporally persistent ventilation abnormalities in patients with asthma contrast with previous in silico modeling studies that suggest that in asthma, ventilation defects may be randomly distributed. In a case study that used pulmonary MRI, CT imaging, and pulmonary function tests, we prospectively evaluated over the course of 7 years, nonidentical female adult twins, each with a lifelong history of asthma. We evaluated pulmonary function and MRI ventilation heterogeneity at baseline and follow-up after 7 years. In both twins, there was a spatially identical MRI ventilation defect and an abnormal subsegmental left-sided upper lobe airway that persisted in the same spatial location after 7 years. If ventilation defects are randomly distributed, this bears a probability of approximately one per 130,000 people. Our MRI observations in related patients with asthma suggest that ventilation abnormalities may not be randomly distributed in patients with asthma and persist distal to airway abnormalities for long periods of time.
近期，肺功能磁共振成像发现哮喘患者在空间和时间上存在持续的通气异常，这与之前电脑模拟的哮喘模型中患者的通气缺陷可能是随机分布的形成对比。在一项使用肺部MRI、CT成像和肺功能测试的病例研究中，我们在7年的前瞻性评估过程中，异卵的成年女性双胞胎，每个人都有终身的哮喘病史。我们在基线和随访7年后评估肺功能和MRI通气的异质性。在所有的双胞胎中， MRI通气缺陷和左侧上叶亚节段性异常气道存在空间上的一致性，且在7年后仍维持在相同的空间位置。如果通风缺陷是随机分布的，其概率约为每13万人中有1人。我们对相关哮喘患者的MRI观察提示，哮喘患者的通气异常可能不是随机分布的，而是长期存在于远端气道异常。
(中日友好医院呼吸与危重症医学科 张清 摘译 林江涛 审校)
(Chest. 2019 Dec;156(6):e111-e116. doi: 10.1016/j.chest.2019.08.004)
(Chest. 2019 Dec;156(6):e111-e116. doi: 10.1016/j.chest.2019.08.004)
Nonidentical Twins With Asthma: Spatially Matched CT Airway and MRI Ventilation Abnormalities.
Eddy RL, Matheson AM, Svenningsen S, Knipping D, Licskai C, McCormack DG, Parraga G.
Abstract
Recent pulmonary functional MRI findings of spatially and temporally persistent ventilation abnormalities in patients with asthma contrast with previous in silico modeling studies that suggest that in asthma, ventilation defects may be randomly distributed. In a case study that used pulmonary MRI, CT imaging, and pulmonary function tests, we prospectively evaluated over the course of 7 years, nonidentical female adult twins, each with a lifelong history of asthma. We evaluated pulmonary function and MRI ventilation heterogeneity at baseline and follow-up after 7 years. In both twins, there was a spatially identical MRI ventilation defect and an abnormal subsegmental left-sided upper lobe airway that persisted in the same spatial location after 7 years. If ventilation defects are randomly distributed, this bears a probability of approximately one per 130,000 people. Our MRI observations in related patients with asthma suggest that ventilation abnormalities may not be randomly distributed in patients with asthma and persist distal to airway abnormalities for long periods of time.
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流感住院哮喘患者全身和局部炎症的模式
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