Recent pulmonary functional MRI findings of spatially and temporally persistent ventilation abnormalities in patients with asthma contrast with previous in silico modeling studies that suggest that in asthma, ventilation defects may be randomly distributed. In a case study that used pulmonary MRI, CT imaging, and pulmonary function tests, we prospectively evaluated over the course of 7 years, nonidentical female adult twins, each with a lifelong history of asthma. We evaluated pulmonary function and MRI ventilation heterogeneity at baseline and follow-up after 7 years. In both twins, there was a spatially identical MRI ventilation defect and an abnormal subsegmental left-sided upper lobe airway that persisted in the same spatial location after 7 years. If ventilation defects are randomly distributed, this bears a probability of approximately one per 130,000 people. Our MRI observations in related patients with asthma suggest that ventilation abnormalities may not be randomly distributed in patients with asthma and persist distal to airway abnormalities for long periods of time.

中文翻译：

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患有哮喘的异卵双胞胎

最近对哮喘患者空间和时间持续性通气异常的肺功能 MRI 发现与之前的计算机模拟研究形成对比，该研究表明在哮喘中，通气缺陷可能是随机分布的。在一项使用肺 MRI、CT 成像和肺功能检查的案例研究中，我们在 7 年的时间里前瞻性地评估了不同的成年女性双胞胎，每个双胞胎都有终生的哮喘病史。我们评估了基线和 7 年后随访时的肺功能和 MRI 通气异质性。在这对双胞胎中，存在空间相同的 MRI 通气缺陷和异常的亚节段左侧上叶气道，在 7 年后仍然存在于相同的空间位置。如果通风缺陷是随机分布的，这大概是每 130,000 人中就有一个的概率。我们对相关哮喘患者的 MRI 观察表明，通气异常可能不是随机分布在哮喘患者中，并且会在气道远端持续很长时间。