Hyperpolarised 3He ventilation-MRI, anatomical lung MRI, lung clearance index (LCI), low-dose CT and spirometry were performed on 19 children (6–16 years) with clinically stable mild cystic fibrosis (CF) (FEV1>−1.96), and 10 controls. All controls had normal spirometry, MRI and LCI. Ventilation-MRI was the most sensitive method of detecting abnormalities, present in 89% of patients with CF, compared with CT abnormalities in 68%, LCI 47% and conventional MRI 22%. Ventilation defects were present in the absence of CT abnormalities and in patients with normal physiology, including LCI. Ventilation-MRI is thus feasible in young children, highly sensitive and provides additional information about lung structure–function relationships.
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Helen Marshall and Alex Horsley are joint first authors.
Contributors HM: MRI acquisition and analysis, overall data analysis, co-wrote the manuscript. AH: study design, MBW set-up and over-read of analysis, co-wrote the manuscript. CJT: study design, patient recruitment, reviewed the manuscript. LS: performed and analysed lung function and MBW measurements, reviewed the manuscript. DH: scored CT images and reviewed all MRI, reviewed the manuscript. FCH: performed MBW measurements, MRI acquisition, reviewed the manuscript. AJS: scored CT images, reviewed the manuscript. JP-R: polarised gas. PJH: MR image registration. GN, NJS and GJC: polarised gas, technical imaging support. DT: statistical support. SC: study design, reviewed the manuscript. IA: patient recruitment and consent, reviewed the manuscript. JMW: study design, MRI acquisition design, data analysis, co-wrote the manuscript, underwrites the work. The corresponding author had access to all the data in the study and accepts responsibility for its validity.
Funding This article presents independent research funded by the Cystic Fibrosis Trust and the National Institute of Health Research (NIHR).
Disclaimer The funders had no role in the study design, data collection, analysis, interpretation or preparation of this report. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.
Competing interests None declared.
Patient consent Obtained.
Ethics approval National Research and Ethics Committee.
Provenance and peer review Not commissioned; externally peer reviewed.
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