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European Radiology

, Volume 15, Issue 9, pp 1978–1986 | Cite as

Perfusion abnormalities in congenital and neoplastic pulmonary disease: comparison of MR perfusion and multislice CT imaging

  • Daniel T. Boll
  • Jonathan S. Lewin
  • Philip Young
  • Ernest S. Siwik
  • Robert C. Gilkeson
Chest

Abstract

The aim of this work was to assess magnetic resonance (MR) perfusion patterns of chronic, nonembolic pulmonary diseases of congenital and neoplastic origin and to compare the findings with results obtained with pulmonary, contrast-enhanced multislice computed tomography (CT) imaging to prove that congenital and neoplastic pulmonary conditions require MR imaging over the pulmonary perfusion cycle to successfully and directly detect changes in lung perfusion patterns. Twenty-five patients underwent concurrent CT and MR evaluation of chronic pulmonary diseases of congenital (n=15) or neoplastic (n=10) origin. Analysis of MR perfusion and contrast-enhanced CT datasets was realized by defining pulmonary and vascular regions of interest in corresponding positions. MR perfusion calculated time-to-peak enhancement, maximal enhancement and the area under the perfusion curve. CT datasets provided pulmonary signal-to-noise ratio measurements. Vessel centerlines of bronchial arteries were determined. Underlying perfusion type, such as pulmonary arterial or systemic arterial supply, as well as regions with significant variations in perfusion were determined statistically. Analysis of the pulmonary perfusion pattern detected pulmonary arterial supply in 19 patients; six patients showed systemic arterial supply. In pulmonary arterial perfusion, MR and multislice CT imaging consistently detected the perfusion type and regions with altered perfusion patterns. In bronchial arterial supply, MR perfusion and CT imaging showed significant perfusion differences. Patients with bronchial arterial supply had bronchial arteries ranging from 2.0 to 3.6 mm compared with submillimeter diameters in pulmonary arterial perfusion. Dynamic MR imaging of congenital and neoplastic pulmonary conditions allowed characterization of the pulmonary perfusion type. CT imaging suggested the presence of systemic arterial perfusion by visualizing hypertrophied bronchial arteries.

Keywords

Multidetector row computed tomography  Magnetic resonance perfusion study Lung perfusion Blood vessels’ flow dynamics 

Supplementary material

Movie 1 The same patient as in Fig. 1. The detected perfusion deficit as seen by dynamic MR perfusion imaging. Note the simultaneous enhancement of pulmonary arteries and the lung parenchyma followed by the aortic arch

330_2005_2748_ESM_movie1.zip (791 kb)
AVI in zip-archive (791 KB)

Movie 2 The same patient as in Fig. 2. Dynamic MR perfusion imaging allowed identification of early pulmonary perfusion of the left lung and subsequent bronchial arterial supply of the right lung. Note the simultaneous enhancement of pulmonary arteries and lung on the left followed by aortic and pulmonary enhancement on the right, representing systemic arterial supply to the right lung

330_2005_2748_ESM_movie2.zip (1.7 mb)
AVI in zip-archive (1.7 MB)

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Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • Daniel T. Boll
    • 1
    • 2
  • Jonathan S. Lewin
    • 3
  • Philip Young
    • 1
  • Ernest S. Siwik
    • 4
  • Robert C. Gilkeson
    • 1
  1. 1.Department of Radiology, University Hospitals of ClevelandCase Western Reserve UniversityClevelandUSA
  2. 2.Department of RadiologyUniversity Hospitals of UlmUlmGermany
  3. 3.Department of Radiology and Radiological ScienceJohns Hopkins Medical InstitutionsBaltimoreUSA
  4. 4.Department of Pediatric Cardiology, Rainbow Babies and Children’s HospitalCase Western Reserve UniversityClevelandUSA

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