磁共振成像评估哮喘患者支气管壁厚度
2022/01/28
摘要
背景:支气管增厚是哮喘的一种病理特征，可以通过一种电离辐射技术计算机断层扫描(CT)来进行评估。目前磁共振成像(MRI)与超短回波时间(UTE)脉冲序列可以成为CT之外的其他选择。
目的：本研究的主要目的是通过评估MRI-UTE与CT的准确性和一致性，比较重度和非重度哮喘患者的差异以及与肺功能测试的相关性，来测量哮喘患者的支气管尺寸。
方法：对15例非重度哮喘患者和15例年龄、性别匹配的重度哮喘患者(NCT03089346)的支气管壁面积(WA)、管腔面积(LA)、归一化壁面积(WA%)和壁厚(WT)进行MRI-UTE和CT评估。MRI和CT的准确性和一致性通过配对t检验和Bland-Altman分析进行评估。使用类内相关系数和Bland-Altman分析评估重现性。采用t检验、Mann-Whitney检验或Fisher精确检验对非严重和严重哮喘参数进行比较。相关性采用Pearson或Spearman系数进行评估。
结果：LA、WA%和WT在MRI-UTE和CT测量中差异无统计学意义，相关性和一致性较好。观察者间和观察者内的重现性中等至良好。与非严重哮喘患者相比，严重哮喘患者WA%和WT均较高。WA、WA%和WT均与1 s内用力呼气量呈负相关。
结论:MRI-UTE是一种准确可靠的无辐射评估哮喘支气管壁尺寸的方法，具有足够的空间分辨率来区分严重和非严重哮喘。
Evaluation of bronchial wall thickness in asthma using magnetic resonance imaging
Benlala I, Dournes G, Girodet PO, et al.
Abstract
BACKGROUND：Bronchial thickening is a pathological feature of asthma that has been evaluated using computed tomography (CT), an ionising radiation technique. Magnetic resonance imaging (MRI) with ultrashort echo time (UTE) pulse sequences could be an alternative to CT.
OBJECTIVE:The primary aim of this study was to measure bronchial dimensions using MRI-UTE in asthmatic patients by evaluating the accuracy and agreement with CT, by comparing severe and non-severe asthma and by correlating with pulmonary function tests.
METHODS:We assessed the bronchial dimensions of wall area (WA), lumen area (LA), normalized wall area (WA%) and wall thickness (WT) by MRI-UTE and CT in 15 patients with non-severe asthma and 15 age- and sex-matched patients with severe asthma (NCT03089346). Accuracy and agreement between MRI and CT was evaluated using paired t-tests and Bland–Altman analysis. Reproducibility was assessed using the intra-class correlation coefficient and Bland–Altman analysis. Non-severe and severe asthmatic parameters were compared using t-tests, Mann–Whitney tests or Fisher's exact tests. Correlations were assessed by Pearson or Spearman coefficients.
RESULTS:LA, WA% and WT were not significantly different when measured by MRI-UTE and CT, with good correlation and concordance. Inter- and intra-observer reproducibility was moderate to good. WA% and WT were both higher in patients with severe asthma compared to non-severe asthma. WA, WA% and WT were all negatively correlated with forced expiratory volume in 1 s.
CONCLUSIONS:We have demonstrated that MRI-UTE is an accurate and reliable radiation-free method to assess bronchial wall dimensions in asthma, with enough spatial resolution to differentiate severe from non-severe asthma.
背景:支气管增厚是哮喘的一种病理特征，可以通过一种电离辐射技术计算机断层扫描(CT)来进行评估。目前磁共振成像(MRI)与超短回波时间(UTE)脉冲序列可以成为CT之外的其他选择。
目的：本研究的主要目的是通过评估MRI-UTE与CT的准确性和一致性，比较重度和非重度哮喘患者的差异以及与肺功能测试的相关性，来测量哮喘患者的支气管尺寸。
方法：对15例非重度哮喘患者和15例年龄、性别匹配的重度哮喘患者(NCT03089346)的支气管壁面积(WA)、管腔面积(LA)、归一化壁面积(WA%)和壁厚(WT)进行MRI-UTE和CT评估。MRI和CT的准确性和一致性通过配对t检验和Bland-Altman分析进行评估。使用类内相关系数和Bland-Altman分析评估重现性。采用t检验、Mann-Whitney检验或Fisher精确检验对非严重和严重哮喘参数进行比较。相关性采用Pearson或Spearman系数进行评估。
结果：LA、WA%和WT在MRI-UTE和CT测量中差异无统计学意义，相关性和一致性较好。观察者间和观察者内的重现性中等至良好。与非严重哮喘患者相比，严重哮喘患者WA%和WT均较高。WA、WA%和WT均与1 s内用力呼气量呈负相关。
结论:MRI-UTE是一种准确可靠的无辐射评估哮喘支气管壁尺寸的方法，具有足够的空间分辨率来区分严重和非严重哮喘。
（中日友好医院呼吸与危重症医学科 李春晓 摘译 林江涛 审校）
（European Respiratory Journal, 2022, 59(1).）
（European Respiratory Journal, 2022, 59(1).）
Evaluation of bronchial wall thickness in asthma using magnetic resonance imaging
Benlala I, Dournes G, Girodet PO, et al.
Abstract
BACKGROUND：Bronchial thickening is a pathological feature of asthma that has been evaluated using computed tomography (CT), an ionising radiation technique. Magnetic resonance imaging (MRI) with ultrashort echo time (UTE) pulse sequences could be an alternative to CT.
OBJECTIVE:The primary aim of this study was to measure bronchial dimensions using MRI-UTE in asthmatic patients by evaluating the accuracy and agreement with CT, by comparing severe and non-severe asthma and by correlating with pulmonary function tests.
METHODS:We assessed the bronchial dimensions of wall area (WA), lumen area (LA), normalized wall area (WA%) and wall thickness (WT) by MRI-UTE and CT in 15 patients with non-severe asthma and 15 age- and sex-matched patients with severe asthma (NCT03089346). Accuracy and agreement between MRI and CT was evaluated using paired t-tests and Bland–Altman analysis. Reproducibility was assessed using the intra-class correlation coefficient and Bland–Altman analysis. Non-severe and severe asthmatic parameters were compared using t-tests, Mann–Whitney tests or Fisher's exact tests. Correlations were assessed by Pearson or Spearman coefficients.
RESULTS:LA, WA% and WT were not significantly different when measured by MRI-UTE and CT, with good correlation and concordance. Inter- and intra-observer reproducibility was moderate to good. WA% and WT were both higher in patients with severe asthma compared to non-severe asthma. WA, WA% and WT were all negatively correlated with forced expiratory volume in 1 s.
CONCLUSIONS:We have demonstrated that MRI-UTE is an accurate and reliable radiation-free method to assess bronchial wall dimensions in asthma, with enough spatial resolution to differentiate severe from non-severe asthma.
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季节性气道微生物群与转录组相互作用促进儿童哮喘发作
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哮喘日间症状日记(ADSD)和哮喘夜间症状日记(ANSD)：新患者报告症状监测的测量特性
