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Assessment of lung perfusion impairment in patients with pulmonary artery‐occlusive and chronic obstructive pulmonary diseases with noncontrast electrocardiogram‐gated fast‐spin‐echo perfusion MR imaging
Author(s) -
Ogasawara Nobuhiko,
Suga Kazuyoshi,
Zaki Mohammed,
Okada Munemasa,
Kawakami Yasuhiko,
Matsunaga Naofumi
Publication year - 2004
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.20150
Subject(s) - medicine , perfusion , lung , pulmonary artery , perfusion scanning , blood flow , radiology , copd , cardiology , nuclear medicine
Purpose To evaluate the ability of noncontrast electrocardiogram (ECG)‐gated fast‐spin‐echo (FSE) perfusion MR images for defining regional lung perfusion impairment, as compared with technetium (Tc)‐99m macroaggregated albumin (MAA) single‐photon emission computed tomography (SPECT) images. Materials and Methods After acquisition of ECG‐gated multiphase FSE MR images during cardiac cycles at selected lung levels in nine healthy volunteers, 11 patients with pulmonary artery–occlusive diseases, and 15 patients with chronic obstructive pulmonary diseases (COPD), the subtracted perfusion‐weighted (PW) MR images were obtained from the two‐phase images of the minimum lung signal intensity (SI) during systole and the maximum SI during diastole, and were compared with SPECT images. Results ECG‐gated PW images showed uniform but posture‐dependent perfusion gradient in normal lungs and visualized the various sizes of perfusion defects in affected lungs. These defect sites were nearly consistent with those on SPECT images, with a significant correlation for the affected‐to‐unaffected perfusion contrast (r = 0.753; P < 0.0001). These MR images revealed that the pulmonary arterial blood flow in the affected areas of COPD was relatively preserved as compared with pulmonary artery–occlusive diseases, and also showed significant decrease in blood flow, even in the areas with homogeneous perfusion on SPECT images in patients with focal pulmonary emphysema. Conclusion This noninvasive MR technique allows qualitative and quantitative assessment of lung perfusion, and may better characterize regional perfusion impairment in pulmonary artery–occlusive diseases and COPD. J. Magn. Reson. Imaging 2004;20:601–611. © 2004 Wiley‐Liss, Inc.