Quantitative and Semiquantitative Measures of Regional Pulmonary Microvascular Perfusion by Magnetic Resonance Imaging and Their Relationships to Global Lung Perfusion and Lung Diffusing Capacity: The Multiethnic Study of Atherosclerosis Chronic Obstructive Pulmonary Disease Study

ObjectivesThe aim of this study was to evaluate the quantitative and semiquantitative measures of regional pulmonary parenchymal perfusion in patients with chronic obstructive pulmonary disease (COPD) in relationship to global lung perfusion (GLP) and lung diffusing capacity (DLCO). Materials and MethodsA total of 143 participants in the Multiethnic Study of Atherosclerosis COPD Study were examined by dynamic contrast-enhanced pulmonary perfusion magnetic resonance imaging (MRI) at 1.5 T. Pulmonary microvascular blood flow (PBF) was calculated on a pixel-by-pixel basis by using a dual-bolus technique and the Fermi function model. Semiquantitative parameters for regional pulmonary microvascular perfusion were calculated from signal intensity-time curves in the lung parenchyma. Intraoberserver and interobserver coefficients of variation (CVs) and correlations between quantitative and semiquantitative MRI parameters and with GLP and DLCO were determined. ResultsQuantitative and semiquantitative parameters of pulmonary microvascular perfusion were reproducible, with CVs for all parameters of less than 10%. Furthermore, these MRI parameters were correlated with GLP and DLCO, and there was good agreement between PBF and GLP. Quantitative and semiquantitative MRI parameters were closely correlated (eg, r = 0.86 for maximum signal increase with PBF). In participants without COPD, the physiological distribution of pulmonary perfusion could be determined by regional MRI measurements. ConclusionRegional pulmonary microvascular perfusion can reliably be quantified from dynamic contrast-enhanced MRI. Magnetic resonance imaging–derived quantitative and semiquantitative perfusion measures correlate with GLP and DLCO.

[1]  A. Malich,et al.  Quantitative evaluation of MR perfusion imaging using blood pool contrast agent in subjects without pulmonary diseases and in patients with pulmonary embolism , 2012, European Radiology.

[2]  B. Jonson,et al.  Ventilation/perfusion SPECT in chronic obstructive pulmonary disease: an evaluation by reference to symptoms, spirometric lung function and emphysema, as assessed with HRCT , 2011, European Journal of Nuclear Medicine and Molecular Imaging.

[3]  J. Stockman.  The Association of Pipe and Cigar Use With Cotinine Levels, Lung Function, and Airflow Obstruction: A Cross-sectional Study , 2011 .

[4]  A. Spanevello,et al.  The role of the bronchial microvasculature in the airway remodelling in asthma and COPD , 2010, Respiratory research.

[5]  J. Hankinson,et al.  Performance of American Thoracic Society-recommended spirometry reference values in a multiethnic sample of adults: the multi-ethnic study of atherosclerosis (MESA) lung study. , 2010, Chest.

[6]  F. García-Río,et al.  Lung volume reference values for women and men 65 to 85 years of age. , 2009, American journal of respiratory and critical care medicine.

[7]  Peter M Jakob,et al.  Quantitative contrast‐enhanced perfusion measurements of the human lung using the prebolus approach , 2009, Journal of magnetic resonance imaging : JMRI.

[8]  J Paul Finn,et al.  Adult Tetralogy of Fallot: Quantitative Assessment of Pulmonary Perfusion With Time-Resolved Three Dimensional Magnetic Resonance Angiography , 2009, Investigative radiology.

[9]  Haosen Zhang,et al.  Fast mapping of myocardial blood flow with MR first‐pass perfusion imaging , 2008, Magnetic resonance in medicine.

[10]  Charles A Powell,et al.  Plasma carbonyls do not correlate with lung function or computed tomography measures of lung density in older smokers. , 2008, Biomarkers : biochemical indicators of exposure, response, and susceptibility to chemicals.

[11]  Anthony P Reeves,et al.  Impaired flow-mediated dilation is associated with low pulmonary function and emphysema in ex-smokers: the Emphysema and Cancer Action Project (EMCAP) Study. , 2007, American journal of respiratory and critical care medicine.

[12]  H. Kauczor,et al.  Proton MRI in COPD , 2007, COPD.

[13]  K. Murase,et al.  Assessment of bolus injection protocol with appropriate concentration for quantitative assessment of pulmonary perfusion by dynamic contrast‐enhanced MR imaging , 2007, Journal of magnetic resonance imaging : JMRI.

[14]  Wolfhard Semmler,et al.  Dual‐bolus approach to quantitative measurement of pulmonary perfusion by contrast‐enhanced MRI , 2006, Journal of magnetic resonance imaging : JMRI.

[15]  Jie Zheng,et al.  Improvement of quantification of myocardial first‐pass perfusion mapping: A temporal and spatial wavelet denoising method , 2006, Magnetic resonance in medicine.

[16]  J. Hankinson,et al.  Standardisation of the single-breath determination of carbon monoxide uptake in the lung , 2005, European Respiratory Journal.

[17]  G. Viegi,et al.  Standardisation of the measurement of lung volumes , 2005, European Respiratory Journal.

[18]  J. Hankinson,et al.  Standardisation of spirometry , 2005, European Respiratory Journal.

[19]  Kenya Murase,et al.  Quantitative assessment of regional pulmonary perfusion in the entire lung using three‐dimensional ultrafast dynamic contrast‐enhanced magnetic resonance imaging: Preliminary experience in 40 subjects , 2004, Journal of magnetic resonance imaging : JMRI.

[20]  Konstantin Nikolaou,et al.  Quantification of Pulmonary Blood Flow and Volume in Healthy Volunteers by Dynamic Contrast-Enhanced Magnetic Resonance Imaging Using a Parallel Imaging Technique , 2004, Investigative radiology.

[21]  W. MacNee,et al.  Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper , 2004, European Respiratory Journal.

[22]  R. Kronmal,et al.  Multi-Ethnic Study of Atherosclerosis: objectives and design. , 2002, American journal of epidemiology.

[23]  Tilo Winkler,et al.  Topographical distribution of pulmonary perfusion and ventilation, assessed by PET in supine and prone humans. , 2002, Journal of applied physiology.

[24]  V. Peinado,et al.  Characterization of pulmonary vascular remodelling in smokers and patients with mild COPD , 2002, European Respiratory Journal.

[25]  D. Altman,et al.  Measuring agreement in method comparison studies , 1999, Statistical methods in medical research.

[26]  J L Hankinson,et al.  Spirometric reference values from a sample of the general U.S. population. , 1999, American journal of respiratory and critical care medicine.

[27]  R. Wilson,et al.  Magnetic resonance quantification of the myocardial perfusion reserve with a Fermi function model for constrained deconvolution. , 1998, Medical physics.

[28]  M. Welch,et al.  Measurement of regional pulmonary blood flow with PET. , 1995, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[29]  B. Rosen,et al.  Pitfalls in MR measurement of tissue blood flow with intravascular tracers: Which mean transit time? , 1993, Magnetic resonance in medicine.

[30]  M. Mintun,et al.  Quantitative measurement of regional pulmonary blood flow with positron emission tomography. , 1986, Journal of applied physiology.

[31]  P. Clayton,et al.  Lung volumes in healthy nonsmoking adults. , 1982, Bulletin europeen de physiopathologie respiratoire.

[32]  F. Meade,et al.  A theoretical and experimental analysis of anomalies in the estimation of pulmonary diffusing capacity by the single breath method. , 1961, Quarterly journal of experimental physiology and cognate medical sciences.

[33]  K. Zierler,et al.  On the theory of the indicator-dilution method for measurement of blood flow and volume. , 1954, Journal of applied physiology.