Background As an increasing number of patients exhibit concomitant cardiac and pulmonary disease, limitations of standard diagnostic criteria are more frequently encountered. Here, we apply noninvasive 129Xe magnetic resonance imaging (MRI) and spectroscopy to identify patterns of regional gas transfer impairment and haemodynamics that are uniquely associated with chronic obstructive pulmonary disease (COPD), idiopathic pulmonary fibrosis (IPF), left heart failure (LHF) and pulmonary arterial hypertension (PAH). Methods Healthy volunteers (n=23) and patients with COPD (n=8), IPF (n=12), LHF (n=6) and PAH (n=10) underwent 129Xe gas transfer imaging and dynamic spectroscopy. For each patient, three-dimensional maps were generated to depict ventilation, barrier uptake (129Xe dissolved in interstitial tissue) and red blood cell (RBC) transfer (129Xe dissolved in RBCs). Dynamic 129Xe spectroscopy was used to quantify cardiogenic oscillations in the RBC signal amplitude and frequency shift. Results Compared with healthy volunteers, all patient groups exhibited decreased ventilation and RBC transfer (both p≤0.01). Patients with COPD demonstrated more ventilation and barrier defects compared with all other groups (both p≤0.02). In contrast, IPF patients demonstrated elevated barrier uptake compared with all other groups (p≤0.007), and increased RBC amplitude and shift oscillations compared with healthy volunteers (p=0.007 and p≤0.01, respectively). Patients with COPD and PAH both exhibited decreased RBC amplitude oscillations (p=0.02 and p=0.005, respectively) compared with healthy volunteers. LHF was distinguishable from PAH by enhanced RBC amplitude oscillations (p=0.01). Conclusion COPD, IPF, LHF and PAH each exhibit unique 129Xe MRI and dynamic spectroscopy signatures. These metrics may help with diagnostic challenges in cardiopulmonary disease and increase understanding of regional lung function and haemodynamics at the alveolar–capillary level. Different heart and lung diseases exhibit unique 129Xe MRI and spectroscopy signatures. These may help differentiate cardiopulmonary disease and increase our understanding of regional lung function and haemodynamics at the alveolar–capillary level. http://bit.ly/2lZCsQy

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不同的心肺疾病与不同的氙 MRI 特征相关

背景 随着越来越多的患者同时出现心脏和肺部疾病，标准诊断标准的局限性也越来越常见。在这里，我们应用无创 129Xe 磁共振成像 (MRI) 和光谱来识别与慢性阻塞性肺病 (COPD)、特发性肺纤维化 (IPF)、左心衰竭 (LHF) 独特相关的区域气体转移障碍和血液动力学的模式和肺动脉高压（PAH）。方法健康志愿者（n=23）和COPD（n=8）、IPF（n=12）、LHF（n=6）和PAH（n=10）患者接受129Xe气体转移成像和动态光谱分析。为每位患者生成三维地图来描绘通气情况，屏障摄取（129Xe 溶解在间质组织中）和红细胞 (RBC) 转移（129Xe 溶解在 RBC 中）。动态 129Xe 光谱用于量化 RBC 信号幅度和频移中的心源性振荡。结果与健康志愿者相比，所有患者组均表现出通气量和红细胞转移减少（均p≤0.01）。与所有其他组相比，COPD 患者表现出更多的通气和屏障缺陷（均 p≤0.02）。相反，与所有其他组相比，IPF 患者表现出更高的屏障摄取（p≤0.007），与健康志愿者相比，红细胞振幅和位移振荡增加（分别为 p=0.007 和 p≤0.01）。与健康志愿者相比，COPD 和 PAH 患者的红细胞振幅振荡均减少（分别为 p=0.02 和 p=0.005）。LHF 与 PAH 的区别在于增强的 RBC 振幅振荡 (p=0.01)。结论 COPD、IPF、LHF 和 PAH 均表现出独特的 129Xe MRI 和动态光谱特征。这些指标可能有助于应对心肺疾病的诊断挑战，并增加对肺泡 - 毛细血管水平的局部肺功能和血液动力学的了解。不同的心脏和肺部疾病表现出独特的 129Xe MRI 和光谱特征。这些可能有助于区分心肺疾病并增加我们对肺泡 - 毛细血管水平的局部肺功能和血流动力学的理解。http://bit.ly/2lZCsQy 这些指标可能有助于应对心肺疾病的诊断挑战，并增加对肺泡 - 毛细血管水平的局部肺功能和血液动力学的了解。不同的心脏和肺部疾病表现出独特的 129Xe MRI 和光谱特征。这些可能有助于区分心肺疾病，并增加我们对肺泡 - 毛细血管水平的局部肺功能和血流动力学的理解。http://bit.ly/2lZCsQy 这些指标可能有助于应对心肺疾病的诊断挑战，并增加对肺泡 - 毛细血管水平的局部肺功能和血液动力学的了解。不同的心脏和肺部疾病表现出独特的 129Xe MRI 和光谱特征。这些可能有助于区分心肺疾病，并增加我们对肺泡 - 毛细血管水平的局部肺功能和血流动力学的理解。http://bit.ly/2lZCsQy