Acute COPD exacerbation: 3 T MRI evaluation of pulmonary regional perfusion--preliminary experience.
OBJECTIVE
To compare pulmonary perfusion parameters by means of dynamic perfusion magnetic resonance in patients affected by chronic obstructive pulmonary disease (COPD), during and after acute exacerbation.


METHODS
Fifteen patients were successfully evaluated with perfusional MRI during an acute exacerbation of COPD and upon clinical stabilization. Inclusion criteria were a PaCO2 > 45 mmHg and respiratory acidosis (arterial blood pH < 7.35) at admittance.


RESULTS
In the acute phase a reduction of pulmonary blood flow (PBF) and pulmonary blood volume (PBV), and a significant prolonging of the mean transit time (MTT) and time to peak (TTP) were observed in all patients. In the stabilization phase a significant increase of PBF and PBV and a significant reduction of MTT and TTP were observed in 6 patients; no significant variations were observed in the other 9 patients.


CONCLUSIONS
3D time-resolved contrast-enhanced MRI allows quantitative evaluation of pulmonary regional perfusion in patients affected by COPD, identifying patients in which perfusion defects are resolved in the clinical-stabilization phase. This technique might allow the identification of patients in whom vasospasm may be the main responsible of pulmonary hypoperfusion during acute COPD exacerbation, with potential advantages on the clinical management of these patients.
Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiation Therapy, PTV Foundation, "Tor Vergata" Hospital, University of Rome "Tor Vergata", Rome, Italy; Department of Biomedicine and Prevention, University of Rome "Tor Vergata", via montpellier 1, Rome, Italy.
Gianluigi
G
Sergiacomi
Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiation Therapy, PTV Foundation, "Tor Vergata" Hospital, University of Rome "Tor Vergata", Rome, Italy.
Amedeo
A
Taglieri
Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiation Therapy, PTV Foundation, "Tor Vergata" Hospital, University of Rome "Tor Vergata", Rome, Italy.
Antonio
A
Chiaravalloti
Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiation Therapy, PTV Foundation, "Tor Vergata" Hospital, University of Rome "Tor Vergata", Rome, Italy.
Eros
E
Calabria
Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiation Therapy, PTV Foundation, "Tor Vergata" Hospital, University of Rome "Tor Vergata", Rome, Italy.
Silvia
S
Arduini
Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiation Therapy, PTV Foundation, "Tor Vergata" Hospital, University of Rome "Tor Vergata", Rome, Italy.
Daniela
D
Tosti
Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiation Therapy, PTV Foundation, "Tor Vergata" Hospital, University of Rome "Tor Vergata", Rome, Italy.
Daniele
D
Citraro
Pulmonary Fibrosis Clinic, Division of Respiratory Diseases, "Tor Vergata" Hospital, Rome, Italy.
Gabriella
G
Pezzuto
Department of Biomedicine and Prevention, University of Rome "Tor Vergata", via montpellier 1, Rome, Italy. Electronic address: ermannopux@libero.it.
Ermanno
E
Puxeddu
Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiation Therapy, PTV Foundation, "Tor Vergata" Hospital, University of Rome "Tor Vergata", Rome, Italy; Department of Biomedicine and Prevention, University of Rome "Tor Vergata", via montpellier 1, Rome, Italy.
Giovanni
G
Simonetti
D000142:Acidosis, Respiratory / Q000503:physiopathology; D000208:Acute Disease; D000368:Aged; D002245:Carbon Dioxide / Q000097:blood; D005260:Female; D006801:Humans; D001239:Inhalation / Q000502:physiology; D008168:Lung / Q000098:blood supply*; D008279:Magnetic Resonance Imaging; D008297:Male; D010313:Partial Pressure; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology*
D002245:Carbon Dioxide
Acute exacerbation; COPD; MR imaging; Pulmonary perfusion