School-age structural and functional MRI and lung function in children following lung resection for congenital lung malformation in infancy.
Children
Congenital
Infants
Lung
Magnetic resonance imaging
Malformation
Pulmonary
Surgery
Journal
Pediatric radiology
ISSN: 1432-1998
Titre abrégé: Pediatr Radiol
Pays: Germany
ID NLM: 0365332
Informations de publication
Date de publication:
06 2022
06 2022
Historique:
received:
23
04
2021
accepted:
03
02
2022
revised:
21
10
2021
pubmed:
20
3
2022
medline:
16
6
2022
entrez:
19
3
2022
Statut:
ppublish
Résumé
The management of asymptomatic congenital lung malformations is debated. Particularly, there is a lack of information regarding long-term growth and development of the remaining lung in children following lung resection for congenital lung malformations. In addition to conventional pulmonary function tests, we used novel functional magnetic resonance imaging (MRI) methods to measure perfusion and ventilation. To assess functionality of the remaining lung expanded into the thoracic cavity after resection of congenital lung malformations. A prospective, cross-sectional pilot study in five children who had surgery for congenital lung malformations during infancy. Participants had structural and functional MRI as well as spirometry, body plethysmography and multiple breath washout at school age. Structural MRI showed an expansion of the remaining lung in all cases. Fractional ventilation and relative perfusion of the expanded lung were locally decreased in functional MRI. In all other parts of the lungs, fractional ventilation and relative perfusion were normal in all children. There was an association between overall impairment of perfusion and elevated lung clearance index. The results of spirometry and body plethysmography varied between patients, including normal lung function, restriction and obstruction. Fractional ventilation and relative perfusion maps from functional MRI specifically locate impairment of the remaining lung after lung resection. These changes are not captured by conventional measures such as structural MRI and standard pulmonary function tests. Therefore, following lung resection for congenital lung malformation, children should be investigated more systematically with functional lung MRI.
Sections du résumé
BACKGROUND
The management of asymptomatic congenital lung malformations is debated. Particularly, there is a lack of information regarding long-term growth and development of the remaining lung in children following lung resection for congenital lung malformations. In addition to conventional pulmonary function tests, we used novel functional magnetic resonance imaging (MRI) methods to measure perfusion and ventilation.
OBJECTIVE
To assess functionality of the remaining lung expanded into the thoracic cavity after resection of congenital lung malformations.
MATERIALS AND METHODS
A prospective, cross-sectional pilot study in five children who had surgery for congenital lung malformations during infancy. Participants had structural and functional MRI as well as spirometry, body plethysmography and multiple breath washout at school age.
RESULTS
Structural MRI showed an expansion of the remaining lung in all cases. Fractional ventilation and relative perfusion of the expanded lung were locally decreased in functional MRI. In all other parts of the lungs, fractional ventilation and relative perfusion were normal in all children. There was an association between overall impairment of perfusion and elevated lung clearance index. The results of spirometry and body plethysmography varied between patients, including normal lung function, restriction and obstruction.
CONCLUSION
Fractional ventilation and relative perfusion maps from functional MRI specifically locate impairment of the remaining lung after lung resection. These changes are not captured by conventional measures such as structural MRI and standard pulmonary function tests. Therefore, following lung resection for congenital lung malformation, children should be investigated more systematically with functional lung MRI.
Identifiants
pubmed: 35305121
doi: 10.1007/s00247-022-05317-7
pii: 10.1007/s00247-022-05317-7
pmc: PMC9192451
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1255-1265Informations de copyright
© 2022. The Author(s).
Références
Magn Reson Med. 2021 Feb;85(2):1079-1092
pubmed: 32892445
Eur J Radiol. 2013 Dec;82(12):2371-7
pubmed: 24016829
J Pediatr Surg. 2012 May;47(5):852-6
pubmed: 22595560
Early Hum Dev. 2006 May;82(5):289-95
pubmed: 16581208
Fetal Diagn Ther. 2001 May-Jun;16(3):178-86
pubmed: 11316935
Semin Pediatr Surg. 2015 Aug;24(4):187-95
pubmed: 26051052
Am J Respir Crit Care Med. 2004 Aug 15;170(4):414-9
pubmed: 15130906
Semin Fetal Neonatal Med. 2012 Apr;17(2):99-104
pubmed: 22305631
Magn Reson Med. 2013 Sep;70(3):657-63
pubmed: 23813579
Pediatr Radiol. 2021 Jan;51(1):57-65
pubmed: 32860525
Semin Pediatr Surg. 2014 Oct;23(5):270-7
pubmed: 25459011
Eur Respir J. 2017 Dec 7;50(6):
pubmed: 29217601
Radiology. 2011 Aug;260(2):551-9
pubmed: 21586678
Magn Reson Med. 2016 Apr;75(4):1647-53
pubmed: 25965158
Semin Pediatr Surg. 2005 Feb;14(1):16-33
pubmed: 15770585
Magn Reson Med. 2013 Jan;69(1):229-37
pubmed: 22392633
Pediatr Radiol. 2022 Feb;52(2):295-311
pubmed: 34037828
ERJ Open Res. 2021 Mar 08;7(1):
pubmed: 33718489
Eur Respir J. 2005 Aug;26(2):319-38
pubmed: 16055882
Am J Respir Crit Care Med. 2011 Sep 1;184(5):602-15
pubmed: 21885636
Magn Reson Med. 2017 Jan;77(1):336-342
pubmed: 26757102
Am Rev Respir Dis. 1988 Nov;138(5):1314-26
pubmed: 3059893
Pediatr Surg Int. 2012 Dec;28(12):1183-8
pubmed: 23076456
J Pediatr Surg. 2011 May;46(5):829-32
pubmed: 21616235
J Pediatr Surg. 2017 Dec;52(12):1891-1897
pubmed: 28951013
Eur Respir J. 2020 Apr 3;55(4):
pubmed: 31862765
AJR Am J Roentgenol. 2016 Jun;206(6):1315-20
pubmed: 27010969
Eur Respir J. 2021 Jul 8;58(1):
pubmed: 33361098
Pediatr Pulmonol. 2019 Aug;54(8):1326-1334
pubmed: 31012287
J Cyst Fibros. 2019 Jul;18(4):543-550
pubmed: 30348613
Thorax. 2001 Jan;56(1):65-72
pubmed: 11120908
J Thorac Cardiovasc Surg. 1993 Apr;105(4):737-42
pubmed: 8469008
J Pediatr Surg. 2008 Mar;43(3):508-12
pubmed: 18358290
Ann Thorac Surg. 2018 Mar;105(3):909-914
pubmed: 29273322
Am J Respir Crit Care Med. 2004 Aug 1;170(3):319-43
pubmed: 15280177
Pediatr Radiol. 2022 Feb;52(2):312-322
pubmed: 33688989