Mucus Plugs in Asthma at CT Associated with Regional Ventilation Defects at 3He MRI

التفاصيل البيبلوغرافية
العنوان: Mucus Plugs in Asthma at CT Associated with Regional Ventilation Defects at 3He MRI
المؤلفون: Mummy, David G, Dunican, Eleanor M, Carey, Katherine J, Evans, Michael D, Elicker, Brett M, Newell, John D, Gierada, David S, Nagle, Scott K, Schiebler, Mark L, Sorkness, Ronald L, Jarjour, Nizar N, Denlinger, Loren C, Fahy, John V, Fain, Sean B
المصدر: Radiology, vol 303, iss 1
بيانات النشر: eScholarship, University of California, 2022.
سنة النشر: 2022
مصطلحات موضوعية: Male, Respiration Disorders, Helium, Magnetic Resonance Imaging, Medical and Health Sciences, Asthma, X-Ray Computed, Mucus, Nuclear Medicine & Medical Imaging, Good Health and Well Being, Clinical Research, Respiratory, Humans, Biomedical Imaging, Female, Lung, Tomography
الوصف: Background Airway mucus plugs in asthma are associated with exacerbation frequency, increased eosinophilia, and reduced lung function. The relationship between mucus plugs and spatially overlapping ventilation abnormalities observed at hyperpolarized gas MRI has not been assessed quantitatively. Purpose To assess regional associations between CT mucus plugs scored by individual bronchopulmonary segment and corresponding measurements of segmental ventilation defect percentage (VDP) at hyperpolarized helium 3 (3He) MRI. Materials and Methods In this secondary analysis of a Health Insurance Portability and Accountability Act-compliant prospective observational cohort, participants in the Severe Asthma Research Program (SARP) III (NCT01760915) between December 2012 and August 2015 underwent hyperpolarized 3He MRI to determine segmental VDP. Segmental mucus plugs at CT were scored by two readers, with segments scored as plugged only if both readers agreed independently. A linear mixed-effects model controlling for interpatient variability was then used to assess differences in VDP in plugged versus plug-free segments. Results Forty-four participants with asthma were assessed (mean age ± standard deviation, 47 years ± 15; 29 women): 19 with mild-to-moderate asthma and 25 with severe asthma. Mucus plugs were observed in 49 total bronchopulmonary segments across eight of 44 patients. Segments containing mucus plugs had a median segmental VDP of 25.9% (25th-75th percentile, 7.3%-38.3%) versus 1.4% (25th-75th percentile, 0.1%-5.2%; P < .001) in plug-free segments. Similarly, the model estimated a segmental VDP of 18.9% (95% CI: 15.7, 22.2) for mucus-plugged segments versus 5.1% (95% CI: 3.3, 7.0) for plug-free segments (P < .001). Participants with one or more mucus plugs had a median whole-lung VDP of 11.1% (25th-75th percentile, 7.1%-18.9%) versus 3.1% (25th-75th percentile, 1.1%-4.4%) in those without plugs (P < .001). Conclusion Airway mucus plugging at CT was associated with reduced ventilation in the same bronchopulmonary segment at hyperpolarized helium 3 MRI, suggesting that mucus plugging may be an important cause of ventilation defects in asthma. © RSNA, 2021 Online supplemental material is available for this article.
وصف الملف: application/pdf
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=od_______325::4985f27bff4f4f80625d860eca445be7Test
https://escholarship.org/uc/item/59x4r14pTest
حقوق: OPEN
رقم الانضمام: edsair.od.......325..4985f27bff4f4f80625d860eca445be7
قاعدة البيانات: OpenAIRE