Quantitatively Assessed Dynamic Contrast-Enhanced Magnetic Resonance Imaging in Patients With Chronic Obstructive Pulmonary Disease: Correlation of Perfusion Parameters With Pulmonary Function Test and Quantitative Computed Tomography


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Abstract

Objectives:The purpose of this study is to evaluate the correlation of the perfusion parameters of 3-dimensional, contrast-enhanced magnetic resonance (MR) imaging (3D CEMRI) with pulmonary function test (PFT) and quantitative computed tomography (CT) parameters in patients with chronic obstructive pulmonary disease (COPD).Materials and Methods:In 14 patients with COPD, 3D CEMRI was performed. From the signal intensity-time curves, pulmonary blood flow (PBF), pulmonary blood volume (PBV), and mean transit time of each pixel was calculated. From the volumetric CT data, the quantitative parameters including the volume fraction of the lung below −950 Housefield Units (V−950) and mean lung density were assessed. The correlation between the MR perfusion parameters and the parameters from quantitative CT and PFT was assessed using Spearman correlation analysis. The correspondence of the regional impairment of perfusion on MR perfusion maps to the areas of emphysema on quantitative CT maps in each patient was assessed qualitatively using a 4-class visual scoring method by 2 readers.Results:All 3D CEMRI examinations were successfully completed and MR perfusion parameters were obtained in all patients. The Spearman correlation test showed that PBF positively correlated with forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) (R = 0.49, P = 0.044), PBV positively correlated with FEV1/FVC (R = 0.69, P = 0.006) and negatively correlated with V−950 (R = −0.61, P = 0.020), and mean transit time positively correlated with FEV1 (R = 0.63, P = 0.017) and FEV1/FVC (R = 0.76, P = 0.002). The areas of perfusion impairment on PBF and PBV maps were relatively well correlated with the areas of emphysema on CT maps [very good or good: PBF 71.5% (reader 1) and 64.3% (reader 2) of the patients, κ = 0.47 (P < 0.001); PBV 78.6% (reader 1) and 78.6% (reader 2) of the patients, κ = 0.89 (P < 0.001)].Conclusions:This study shows that the deterioration of perfusion parameters measured on MR in patients with COPD, correlates with worsening of airflow limitation on PFT and emphysema index on CT. Regional heterogeneity of emphysema on CT matches with the decreased perfusion on MR.

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