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.
OBJECTIVE
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.


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.


CONCLUSIONS
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.
Ogasawara
Nobuhiko
N
Department of Radiology, Yamaguchi University School of Medicine, Ube, Japan.
Suga
Kazuyoshi
K
Zaki
Mohammed
M
Okada
Munemasa
M
Kawakami
Yasuhiko
Y
Matsunaga
Naofumi
N
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology*; D002648:Child; D004562:Electrocardiography; D005260:Female; D006801:Humans; D016014:Linear Models; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery; D011652:Pulmonary Circulation; D029424:Pulmonary Disease, Chronic Obstructive / Q000000981:diagnostic imaging / Q000503:physiopathology*; D012129:Respiratory Function Tests; D013382:Subtraction Technique; D015899:Tomography, Emission-Computed, Single-Photon