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Functional Evaluation of Emphysema Using Diffusion-Weighted 3Helium-Magnetic Resonance Imaging, High-Resolution Computed Tomography, and Lung Function Tests

Ley, Sebastian MD*∥; Zaporozhan, Julia MS*; Morbach, Andreas MSc*; Eberle, Balthasar MD; Gast, Klaus Kurt MD*; Heussel, Claus Peter MD*; Biedermann, Alexander MD; Mayer, Eckhard MD§; Schmiedeskamp, Joerg MSc; Stepniak, Andreas MD; Schreiber, Wolfgang G. PhD*; Kauczor, Hans-Ulrich MD*∥

doi: 10.1097/01.rli.0000129468.79005.1d
Original Article
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Purpose: To assess the emphysematous enlargement of distal airspaces and concomitant large and small airway disease using diffusion-weighted 3Helium-magnetic resonance imaging (MRI), high-resolution computed tomography (HRCT), and lung function tests (LFT).

Methods: Seven patients were examined after single lung transplantation (LTx) and 1 before double LTx for various forms of emphysema. Five patients after double LTx served as controls. Patients were assessed by 3Helium-MRI (apparent diffusion coefficient [ADC]), HRCT (mean lung density [MLD], emphysema index [EI]), and LFT.

Results: Transplanted lungs: mean ADC = 0.17 cm2/s, MLD = −848 H, EI = 22%. Emphysematous lungs: mean ADC = 0.33 cm2/s, MLD = −922 H; EI = 54%. Good correlations were found between ADC and MLD (r = 0.6), EI (r = 0.8), intrathoracic gas volume (r = 0.7), forced expiratory volume in 1 second (r = 0.7), and forced expiratory flows (r = 0.7). In contrast, HRCT only provided moderate correlations with LFT (EI: r = 0.5; MLD: r [le] 0.4).

Conclusion: In this initial study, 3He-MRI yield good correlations with HRCT and agrees better than HRCT with the functional characterization of emphysema regarding hyperinflation, large and small airway disease as provided by LFT.

From the *Department of Radiology, †Department of Anesthesiology, ‡Department of Pulmonology, §Department of Cardiac, Thoracic and Vascular Surgery, and ¶Institute of Physics, Johannes Gutenberg-University, Mainz; and ∥Department of Radiology, German Cancer Research Center, Heidelberg, Germany.

Received November 14, 2003 and accepted for publication, after revision, February 17, 2004.

Supported by Amersham Health and the German Research Council (DFG FOR 474).

Reprints: Sebastian Ley, MD, E010 – Department of Radiology, Deutsches Krebsforschungszentrum (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany. E-mail: ley@gmx.net

© 2004 Lippincott Williams & Wilkins, Inc.