Noninvasive quantification of alveolar morphometry in elderly never- and ex-smokers


Diffusion‐weighted magnetic resonance imaging (MRI) provides a way to generate in vivo lung images with contrast sensitive to the molecular displacement of inhaled gas at subcellular length scales. Here, we aimed to evaluate hyperpolarized 3He MRI estimates of the alveolar dimensions in 38 healthy elderly never‐smokers (73 ± 6 years, 15 males) and 21 elderly ex‐smokers (70 ± 10 years, 14 males) with (n = 8, 77 ± 6 years) and without emphysema (n = 13, 65 ± 10 years). The ex‐smoker and never‐smoker subgroups were significantly different for FEV1/FVC (P = 0.0001) and DLCO (P = 0.009); while ex‐smokers with emphysema reported significantly diminished FEV1/FVC (P = 0.02) and a trend toward lower DLCO (P = 0.05) than ex‐smokers without emphysema. MRI apparent diffusion coefficients (ADC) and CT measurements of emphysema (relative area–CT density histogram, RA950) were significantly different (P = 0.001 andP = 0.007) for never‐smoker and ex‐smoker subgroups. In never‐smokers, the MRI estimate of mean linear intercept (260 ± 27 μm) was significantly elevated as compared to the results previously reported in younger never‐smokers (210 ± 30 μm), and trended smaller than in the age‐matched ex‐smokers (320 ± 72 μm, P = 0.06) evaluated here. Never‐smokers also reported significantly smaller internal (220 ± 24 μm, P = 0.01) acinar radius but greater alveolar sheath thickness (120 ± 4 μm,P <0.0001) than ex‐smokers. Never‐smokers were also significantly different than ex‐smokers without emphysema for alveolar sheath thickness but not ADC, while ex‐smokers with emphysema reported significantly different ADC but not alveolar sheath thickness compared to ex‐smokers without CT evidence of emphysema. Differences in alveolar measurements in never‐ and ex‐smokers demonstrate the sensitivity of MRI measurements to the different effects of smoking and aging on acinar morphometry.

Keywords:
Acinar duct, emphysema, hyperpolarized 3He magnetic resonance imaging, lung morphometry, senile emphysema.


Autoři: Gregory A. Paulin 1,2;  Alexei Ouriadov 1;  Eric Lessard 1,2;  Khadija Sheikh 1,2;  David G. Mccormack 3;  Grace Parraga 1,2
Působiště autorů: Imaging Research Laboratories, Robarts Research Institute, The University of Western Ontario, London, Ontario, Canada 2 Department of Medical Biophysics, The University of Western Ontario, London, Ontario, Canada 1;  Division of Respirology, Department of Medicine, The University of Western Ontario, London, Ontario, Canada 3
Vyšlo v časopise:
Kategorie: Original Research
prolekare.web.journal.doi_sk: 10.14814/phy2.12583

© 2015 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of the American Physiological Society and The Physiological Society.
This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Souhrn

Diffusion‐weighted magnetic resonance imaging (MRI) provides a way to generate in vivo lung images with contrast sensitive to the molecular displacement of inhaled gas at subcellular length scales. Here, we aimed to evaluate hyperpolarized 3He MRI estimates of the alveolar dimensions in 38 healthy elderly never‐smokers (73 ± 6 years, 15 males) and 21 elderly ex‐smokers (70 ± 10 years, 14 males) with (n = 8, 77 ± 6 years) and without emphysema (n = 13, 65 ± 10 years). The ex‐smoker and never‐smoker subgroups were significantly different for FEV1/FVC (P = 0.0001) and DLCO (P = 0.009); while ex‐smokers with emphysema reported significantly diminished FEV1/FVC (P = 0.02) and a trend toward lower DLCO (P = 0.05) than ex‐smokers without emphysema. MRI apparent diffusion coefficients (ADC) and CT measurements of emphysema (relative area–CT density histogram, RA950) were significantly different (P = 0.001 andP = 0.007) for never‐smoker and ex‐smoker subgroups. In never‐smokers, the MRI estimate of mean linear intercept (260 ± 27 μm) was significantly elevated as compared to the results previously reported in younger never‐smokers (210 ± 30 μm), and trended smaller than in the age‐matched ex‐smokers (320 ± 72 μm, P = 0.06) evaluated here. Never‐smokers also reported significantly smaller internal (220 ± 24 μm, P = 0.01) acinar radius but greater alveolar sheath thickness (120 ± 4 μm,P <0.0001) than ex‐smokers. Never‐smokers were also significantly different than ex‐smokers without emphysema for alveolar sheath thickness but not ADC, while ex‐smokers with emphysema reported significantly different ADC but not alveolar sheath thickness compared to ex‐smokers without CT evidence of emphysema. Differences in alveolar measurements in never‐ and ex‐smokers demonstrate the sensitivity of MRI measurements to the different effects of smoking and aging on acinar morphometry.

Keywords:
Acinar duct, emphysema, hyperpolarized 3He magnetic resonance imaging, lung morphometry, senile emphysema.


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