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Ogasawara, N. et al.

Assessment of lung perfusion impairment in patients with pulmonary artery-occlusive and chronic obstructive pulmonary diseases with noncontrast electrocardiogram-gated fast-spin-echo perfusion MR imaging.

PURPOSE: To evaluate the ability of noncontrast electrocardiogram (ECG)-gated fast-spin-echo (FSE) perfusion MR images for defining regional lung perfusion impairment, as compared with technetium (Tc)-99m macroaggregated albumin (MAA) single-photon emission computed tomography (SPECT) images. MATERIALS AND METHODS: After acquisition of ECG-gated multiphase FSE MR images during cardiac cycles at selected lung levels in nine healthy volunteers, 11 patients with pulmonary artery-occlusive diseases, and 15 patients with chronic obstructive pulmonary diseases (COPD), the subtracted perfusion-weighted (PW) MR images were obtained from the two-phase images of the minimum lung signal intensity (SI) during systole and the maximum SI during diastole, and were compared with SPECT images. RESULTS: ECG-gated PW images showed uniform but posture-dependent perfusion gradient in normal lungs and visualized the various sizes of perfusion defects in affected lungs. These defect sites were nearly consistent with those on SPECT images, with a significant correlation for the affected-to-unaffected perfusion contrast (r = 0.753; P < 0.0001). These MR images revealed that the pulmonary arterial blood flow in the affected areas of COPD was relatively preserved as compared with pulmonary artery-occlusive diseases, and also showed significant decrease in blood flow, even in the areas with homogeneous perfusion on SPECT images in patients with focal pulmonary emphysema. CONCLUSION: This noninvasive MR technique allows qualitative and quantitative assessment of lung perfusion, and may better characterize regional perfusion impairment in pulmonary artery-occlusive diseases and COPD.[1]

References

Assessment of lung perfusion impairment in patients with pulmonary artery-occlusive and chronic obstructive pulmonary diseases with noncontrast electrocardiogram-gated fast-spin-echo perfusion MR imaging. Ogasawara, N., Suga, K., Zaki, M., Okada, M., Kawakami, Y., Matsunaga, N. Journal of magnetic resonance imaging : JMRI. (2004) [Pubmed]

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