哮喘联盟

摘要
   背景：进行³He磁共振影像学（MRI）检查不会出现离子辐射，已经证实能检测哮喘成人患者的局灶性肺部通气和结构异常，但该项检查尚未在哮喘患儿中应用。儿童哮喘患者的局灶性肺通气和微结构检测指标可加深我们对疾病机制的了解。
   目的：本试验研究³He MRI是否能发现与儿童哮喘诊断或呼吸道疾病相关的异常。
   方法：44名年龄为9～10岁的儿童入选此项出生队列研究，这些受试者具有较高的哮喘和过敏性疾病的风险。对于每位受试者，在不同的呼吸动作时获取时间分辨的三维图像系列图像和三维扩散加权图像。对通气缺陷数和大小进行评分，计算3He扩散距离的局灶图和统计值。
   结果：与无哮喘的儿童相比，中度-重度哮喘患儿的平均扩散距离平方根较小(P = 0.004)、扩散距离的局灶SD增加(P = 0.03)、缺陷评分较高(P = 0.03) 。3岁前有鼻病毒感染和喘息病史的儿童，平均扩散距离平方根较小(P = 0.01) 、缺陷评分较高(P = 0.05)。
   结论：与无哮喘的儿童相比，采用3He进行的MRI能检测哮喘患儿更多和更大区域的通气缺陷，以及更大程度的气体扩散受限。 这些检测结果显示局灶性梗阻和外周气道和肺泡腔变小及局部大小变化。

（刘国梁 审校）
JAllergyClinImmunol.2012Dec11.pii:S0091-6749(12)01700-9.doi:10.1016/j.jaci.2012.10.032.[Epub ahead of print]

 

Pulmonary (3)He magnetic resonance imaging of childhood asthma.

Cadman RV, Lemanske Jr RF, Evans MD, Jackson DJ, Gern JE, Sorkness RL, Fain SB.

Source
Department of Medical Physics, School of Medicine and Public Health, Madison, Wis.

Abstract
BACKGROUND: Magnetic resonance imaging (MRI) with (3)He does not require ionizing radiation and has been shown to detect regional abnormalities in lung ventilation and structure in adults with asthma, but the method has not been extended to children with asthma. Measurements of regional lung ventilation and microstructure in subjects with childhood asthma could advance our understanding of disease mechanisms.
OBJECTIVE: We sought to determine whether (3)He MRI in children can identify abnormalities related to the diagnosis of asthma or prior history of respiratory illness.
METHODS: Forty-four children aged 9 to 10 years were recruited from a birth cohort at increased risk of asthma and allergic diseases. For each subject, a time-resolved 3-dimensional image series and a 3-dimensional diffusion-weighted image were acquired in separate breathing maneuvers. The numbers and sizes of ventilation defects were scored, and regional maps and statistics of average (3)He diffusion lengths were calculated.
RESULTS: Children with mild-to-moderate asthma had lower average root-mean-square diffusion length (X(rms)¯) values (P = .004), increased regional SD of diffusion length values (P = .03), and higher defect scores (P = .03) than those without asthma. Children with histories of wheezing illness with rhinovirus infection before the third birthday had lower X(rms)¯ values (P = .01) and higher defect scores (P = .05).
CONCLUSION: MRI with (3)He detected more and larger regions of ventilation defect and a greater degree of restricted gas diffusion in children with asthma compared with those seen in children without asthma. These measures are consistent with regional obstruction and smaller and more regionally variable dimensions of the peripheral airways and alveolar spaces.

JAllergyClinImmunol.2012Dec11.pii:S0091-6749(12)01700-9.doi:10.1016/j.jaci.2012.10.032. [Epub ahead of print]