Direct visualisation of collateral ventilation in COPD with hyperpolarised gas MRI
- Helen Marshall1,
- Martin H Deppe1,
- Juan Parra-Robles1,
- Susan Hillis2,
- Catherine G Billings2,
- Smitha Rajaram1,
- Andrew Swift1,
- Sam R Miller3,
- Joanna H Watson3,
- Jan Wolber4,
- David A Lipson5,
- Rod Lawson2,
- Jim M Wild1
- 1Department of Academic Radiology, University of Sheffield, Sheffield, South Yorkshire, UK
- 2Department of Respiratory Medicine, Sheffield Teaching Hospitals NHS Trust, South Yorkshire, UK
- 3GlaxoSmithKline, Stockley Park, UK
- 4GE Healthcare, Amersham, UK
- 5GlaxoSmithKline, King of Prussia, Pennsylvania, USA
- Correspondence to Professor Jim M Wild, Department of Academic Radiology, C Floor, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, UK;
- Received 27 July 2011
- Accepted 8 January 2012
- Published Online First 27 January 2012
Background Collateral ventilation has been proposed as a mechanism of compensation of respiratory function in obstructive lung diseases but observations of it in vivo are limited. The assessment of collateral ventilation with an imaging technique might help to gain insight into lung physiology and assist the planning of new bronchoscopic techniques for treating emphysema.
Objective To obtain images of delayed ventilation that might be related to collateral ventilation over the period of a single breath-hold in patients with chronic obstructive pulmonary disease (COPD).
Methods Time-resolved breath-hold hyperpolarised 3He MRI was used to obtain images of the progressive influx of polarised gas into initially non-ventilated defects.
Results A time-series of images showed that 3He moves into lung regions which were initially non-ventilated. Ventilation defects with delayed filling were observed in 8 of the 10 patients scanned.
Conclusions A method for direct imaging of delayed ventilation within a single breath-hold has been demonstrated in patients with COPD. Images of what is believed to be collateral ventilation and slow filling of peripheral airspaces due to increased flow resistance are presented. The technique provides 3D whole-lung coverage with sensitivity to regional information, and is non-invasive and non-ionising.
- Collateral ventilation
- COPD pathology
- imaging/CT MRI etc
- lung physiology
- COPD mechanisms
- non-invasive ventilation
- sleep apnoea
- not applicable
- cystic fibrosis
Funding Funded by GlaxoSmithKline (RES111175) and UK EPSRC (EP/D070252/1). Polariser support from GE Healthcare.
Competing interests None.
Ethics approval South Yorkshire REC (REC reference: 10/H1310/11).
Provenance and peer review Not commissioned; externally peer reviewed.