Assessment of the relationship between morphological emphysema phenotype and corresponding pulmonary perfusion pattern on a segmental level

作者：Bryant Mark; Ley Sebastian; Eberhardt Ralf; Menezes Ravi; Herth Felix; Sedlaczek Oliver; Kauczor Hans Ulrich; Ley Zaporozhan Julia^*

来源：European Radiology, 2015, 25(1): 72-80.

DOI：10.1007/s00330-014-3385-5

• Lung
• Emphysema
• CT
• MR perfusion
• Phenotype

Purpose Distinct morphological emphysema phenotypes were assessed by CT to show characteristic perfusion defect patterns.
Material/Methods Forty-one patients with severe emphysema (GOLD III/IV) underwent three-dimensional high resolution computed tomography (3D-HRCT) and contrast-enhanced magnetic resonance (MR) perfusion. 3D-HRCT data was visually analyzed for emphysema phenotyping and quantification by consensus of three experts in chest-radiology. The predominant phenotype per segment was categorized as normal, centrilobular, panlobular or paraseptal. Segmental lung perfusion was visually analyzed using six patterns of pulmonary perfusion (1-normal; 2-mild homogeneous reduction in perfusion; 3-heterogeneous perfusion without focal defects; 4-heterogeneous perfusion with focal defects; 5-heterogeneous absence of perfusion; 6-homogeneous absence of perfusion), with the extent of the defect given as a percentage.
Results 730 segments were evaluated. CT categorized 566 (78 %) as centrilobular, 159 (22 %) as panlobular and 5 (<1 %) as paraseptal with no normals. Scores with regards to MR perfusion patterns were: 1-0; 2-0; 3-28 (4 %); 4-425 (58 %); 5-169 (23 %); 6-108 (15 %). The predominant perfusion pattern matched as follows: 70 % centrilobular emphysema - heterogeneous perfusion with focal defects (score 4); 42 % panlobular - homogeneous absence of perfusion (score 5); and 43 % panlobular - heterogeneous absence of perfusion (score 6).
Conclusion MR pulmonary perfusion patterns correlate with the CT phenotype at a segmental level in patients with severe emphysema.

• 出版日期2015-1