Diverse Cardiopulmonary Diseases are Associated with Distinct Xenon MRI Signatures.
Abstract
BACKGROUND:As an increasing number of patients exhibit concomitant cardiac and pulmonary
disease, limitations of standard diagnostic criteria are more frequently encountered.
Here, we apply noninvasive 129Xenon MR imaging and spectroscopy to identify patterns
of regional gas transfer impairment and hemodynamics that are uniquely associated
with chronic obstructive pulmonary disease (COPD), idiopathic pulmonary fibrosis (IPF),
left heart failure (LHF), and pulmonary arterial hypertension (PAH). METHODS:Healthy
volunteers (n=23) and patients with COPD (n=8), IPF (n=12), LHF (n=6), and PAH (n=10)
underwent 129Xe gas transfer imaging and dynamic spectroscopy. For each patient, 3D
maps were generated to depict ventilation, barrier uptake (129Xe dissolved in interstitial
tissue), and red blood cell (RBC) transfer (129Xe dissolved in RBCs). Dynamic 129Xe
spectroscopy was used to quantify cardiogenic oscillations in the RBC signal amplitude
and frequency shift. RESULTS:Compared to healthy volunteers, all patient groups exhibited
decreased ventilation and RBC transfer (p≤0.01, p≤0.01). Patients with COPD demonstrated
more ventilation and barrier defects compared to all other groups (p≤0.02, p≤0.02).
In contrast, IPF patients demonstrated elevated barrier uptake compared to all other
groups (p≤0.007) and increased RBC amplitude and shift oscillations compared to healthy
volunteers (p=0.007, p≤0.01). Patients with COPD and PAH both exhibited decreased
RBC amplitude oscillations (p=0.02, p=0.005) compared to healthy volunteers. LHF was
distinguishable from PAH by enhanced RBC amplitude oscillations (p=0.01). CONCLUSION:COPD,
IPF, LHF, and PAH each exhibit unique 129Xe MR imaging and dynamic spectroscopy signatures.
These metrics may help with diagnostic challenges in cardiopulmonary disease and increase
understanding of regional lung function and hemodynamics at the alveolar-capillary
level.
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https://hdl.handle.net/10161/19451Published Version (Please cite this version)
10.1183/13993003.00831-2019Publication Info
Wang, Ziyi; Bier, Elianna A; Swaminathan, Aparna; Parikh, Kishan; Nouls, John; He,
Mu; ... Rajagopal, Sudarshan (2019). Diverse Cardiopulmonary Diseases are Associated with Distinct Xenon MRI Signatures.
The European respiratory journal. pp. 1900831-1900831. 10.1183/13993003.00831-2019. Retrieved from https://hdl.handle.net/10161/19451.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Show full item recordScholars@Duke
Bastiaan Driehuys
Professor of Radiology
My research program is focused on developing and applying hyperpolarized gases to
enable fundamentally new applications in MRI. Currently we use this technology to
non-invasively image pulmonary function in 3D. Hyperpolarization involves aligning
nuclei to a high degree to enhance their MRI signal by 5-6 orders of magnitude. Thus,
despite the low density of gases relative to water (the ordinary signal source in
MRI), they can be imaged at high-resolution in a single breath. This technology leads
Sheng Luo
Professor of Biostatistics & Bioinformatics
Joseph George Mammarappallil
Assistant Professor of Radiology
John Claude Nouls
Assistant Professor of Radiology
This author no longer has a Scholars@Duke profile, so the information shown here reflects
their Duke status at the time this item was deposited.
Kishan S Parikh
Assistant Professor of Medicine
Duke University Medical CenterDuke Clinical Research Institute
Sudarshan Rajagopal
Associate Professor of Medicine
I am a physician-scientist with a research focus on G protein-coupled receptor signaling
in inflammation and vascular disease and a clinical focus on pulmonary vascular disease.
I serve as Co-Director of the Duke Pulmonary Vascular Disease Center.
Aparna Swaminathan
Assistant Professor of Medicine
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