Assessment of the relationship between lung parenchymal destruction and impaired pulmonary perfusion on a lobar level in patients with emphysema.
OBJECTIVE
To assess the relationship between lung parenchymal destruction and impaired pulmonary perfusion on a lobar level using CT and MRI in patients with emphysema.


METHODS
Forty-five patients with severe emphysema (GOLD III and IV) underwent inspiratory 3D-HRCT and contrast-enhanced MR-perfusion (1.5T; 3.5mmx1.9mmx4mm). 3D-HRCT data was analyzed using a software for detection and visualization of emphysema. Emphysema was categorized in four clusters with different volumes and presented as overlay on the CT. CT and lung perfusion were visually analyzed for three lobes on each side using a four-point-score to grade the abnormalities on CT (1: predominantly small emphysema-clusters to 4: >75% large emphysema-clusters) and MRI (1: normal perfusion to 4: no perfusion).


RESULTS
A total of 270 lobes were evaluated. At CT, the score was 1 for 9 lobes, 2 for 43, 3 for 77, and 4 for 141 lobes. At MRI, the score was 1 for 13 lobes, 2 for 45, 3 for 92, and 4 for 120 lobes. Matching of lung parenchymal destruction and reduced perfusion was found in 213 lobes (weighted kappa=0.8). The score was higher on CT in 44, and higher on MRI in 13 lobes.


CONCLUSIONS
3D-HRCT and 3D MR-perfusion show a high lobar agreement between parenchymal destruction and reduction of perfusion in patients with severe emphysema.
Ley-Zaporozhan
Julia
J
Department of Radiology, Johannes Gutenberg University, Mainz, Germany. juliazapo@web.de
Ley
Sebastian
S
Eberhardt
Ralf
R
Weinheimer
Oliver
O
Fink
Christian
C
Puderbach
Michael
M
Eichinger
Monika
M
Herth
Felix
F
Kauczor
Hans-Ulrich
HU
D000328:Adult; D000368:Aged; D003287:Contrast Media / Q000008:administration & dosage; D004646:Emphysema / Q000175:diagnosis* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007089:Image Enhancement; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D008168:Lung / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed
D003287:Contrast Media