Increased lung water and tissue damage in bronchopulmonary dysplasia.
OBJECTIVE
To test the hypothesis that high and asymmetrical water content persists in infants with bronchopulmonary dysplasia (BPD) and that this is associated with nonuniform lung damage.


METHODS
Magnetic resonance imaging was used to assess lung water content in 20 infants and tissue injury in 35 infants of 23 to 33 weeks' gestational age (15 with severe BPD, 13 with mild BPD, and 7 without BPD). Relative proton density provided an index of water content and distribution. The location and extent of focal densities and cyst-like appearances indicating lung damage were defined.


RESULTS
Proton density was significantly higher in dependent regions. Average proton density, proton density gradient, and severity of lung damage were greater in infants with severe BPD. Indicators of damage were greatest in dorsal lung regions. BPD was associated with a higher lung water burden and gravity-dependent atelectasis and/or alveolar flooding. Lesions were more common in dorsal lung regions in infants with severe lung damage.


CONCLUSIONS
Infants with BPD have increased lung water and are susceptible to gravity-induced collapse and/or alveolar flooding in the dependent lung. Focal tissue damage appears to be distributed inhomogenously.
Department of Pediatrics, Faculty of Medicine, Imperial College, London, United Kingdom.
Eleri W
EW
Adams
Michael C
MC
Harrison
Serena J
SJ
Counsell
Joanna M
JM
Allsop
Nigel L
NL
Kennea
Joseph V
JV
Hajnal
Anna S
AS
Thornton
Philip
P
Duggan
A David
AD
Edwards
D001997:Bronchopulmonary Dysplasia / Q000473:pathology*; D015633:Extravascular Lung Water; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D008168:Lung / Q000473:pathology*; D012121:Respiration, Artificial; D012720:Severity of Illness Index