TY - MRI的T1 -氙- 129检测通风deficits in paediatric stem cell transplant patients unable to perform spirometry JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.01779-2018 VL - 53 IS - 5 SP - 1801779 AU - Walkup, Laura L. AU - Myers, Kasiani AU - El-Bietar, Javier AU - Nelson, Adam AU - Willmering, Matthew M. AU - Grimley, Michael AU - Davies, Stella M. AU - Towe, Christopher AU - Woods, Jason C. Y1 - 2019/05/01 UR - //www.qdcxjkg.com/content/53/5/1801779.abstract N2 - Background Early detection of pulmonary morbidity following haematopoietic stem cell transplantation (HSCT) remains an important challenge for intervention, primarily due to the insensitivity of spirometry to early change, and in paediatrics, patient compliance provides additional challenges. Regional lung ventilation abnormalities in paediatric HSCT patients were quantified using hyperpolarised xenon-129 (129Xe) magnetic resonance imaging (MRI) and compared to spirometry.Methods Medically stable, paediatric allogeneic HSCT patients (n=23, ages 6–16 years) underwent an outpatient MRI scan where regional ventilation was quantified with a breath-hold of hyperpolarised 129Xe gas. Ventilation deficits, regions of the lung that ventilate poorly due to obstruction, were quantified as a ventilation defect percentage (VDP) and compared to forced expiratory volume in 1 s (FEV1), FEV1/forced vital capacity (FVC) ratio, and forced expiratory flow at 25–75% of FVC (FEF25–75%) from spirometry using linear regression.Results The mean±sd 129Xe VDP was 10.5±9.4% (range 2.6–41.4%). 129Xe VDP correlated with FEV1, FEV1/FVC ratio and FEF25–75% (p≤0.02 for all comparisons). Ventilation deficits were detected in patients with normal spirometry (i.e. FEV1 >80%), supporting the sensitivity of 129Xe MRI to early obstruction reported in other pulmonary conditions. Seven (30%) patients could not perform spirometry, yet ventilation deficits were observed in five of these patients, detecting abnormalities that otherwise may have gone undetected and untreated until advanced.Conclusion Lung ventilation deficits were detected using hyperpolarised 129Xe gas MRI in asymptomatic paediatric HSCT patients and in a subgroup who were unable to perform reliable spirometry. 129Xe MRI provides a reliable imaging-based assessment of pulmonary involvement in this potentially difficult to diagnose paediatric population.Hyperpolarised 129Xe MRI detects regional lung ventilation abnormalities in paediatric stem cell transplantation patients, including in patients with normal spirometry and in patients unable to perform reliable spirometry http://ow.ly/1T2030nGGQ1 ER -