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01-01-2015 | Chest

Assessment of the relationship between morphological emphysema phenotype and corresponding pulmonary perfusion pattern on a segmental level

Authors: Mark Bryant, Sebastian Ley, Ralf Eberhardt, Ravi Menezes, Felix Herth, Oliver Sedlaczek, Hans-Ulrich Kauczor, Julia Ley-Zaporozhan

Published in: European Radiology | Issue 1/2015

Abstract

Purpose

Distinct morphological emphysema phenotypes were assessed by CT to show characteristic perfusion defect patterns.

Material/Methods

Forty-one patients with severe emphysema (GOLD III/IV) underwent three-dimensional high resolution computed tomography (3D-HRCT) and contrast-enhanced magnetic resonance (MR) perfusion. 3D-HRCT data was visually analyzed for emphysema phenotyping and quantification by consensus of three experts in chest-radiology. The predominant phenotype per segment was categorized as normal, centrilobular, panlobular or paraseptal. Segmental lung perfusion was visually analyzed using six patterns of pulmonary perfusion (1-normal; 2-mild homogeneous reduction in perfusion; 3-heterogeneous perfusion without focal defects; 4-heterogeneous perfusion with focal defects; 5-heterogeneous absence of perfusion; 6-homogeneous absence of perfusion), with the extent of the defect given as a percentage.

Results

730 segments were evaluated. CT categorized 566 (78 %) as centrilobular, 159 (22 %) as panlobular and 5 (<1 %) as paraseptal with no normals. Scores with regards to MR perfusion patterns were: 1–0; 2–0; 3–28 (4 %); 4–425 (58 %); 5–169 (23 %); 6–108 (15 %).

The predominant perfusion pattern matched as follows: 70 % centrilobular emphysema - heterogeneous perfusion with focal defects (score 4); 42 % panlobular - homogeneous absence of perfusion (score 5); and 43 % panlobular - heterogeneous absence of perfusion (score 6).

Conclusion

MR pulmonary perfusion patterns correlate with the CT phenotype at a segmental level in patients with severe emphysema.

Key points

• MR perfusion patterns correlate with the CT phenotype in emphysema.

• Reduction of MR perfusion is associated with loss of lung parenchyma on CT

• Centrilobular emphysema shows heterogeneous perfusion reduction while panlobular emphysema shows loss of perfusion.

GOLD (2009) Global Initiative for Chronic Obstructive Lung Disease (GOLD). http://www.goldcopd.com/

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Title: Assessment of the relationship between morphological emphysema phenotype and corresponding pulmonary perfusion pattern on a segmental level
Authors: Mark Bryant
Sebastian Ley
Ralf Eberhardt
Ravi Menezes
Felix Herth
Oliver Sedlaczek
Hans-Ulrich Kauczor
Julia Ley-Zaporozhan
Publication date: 01-01-2015
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 1/2015
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-014-3385-5

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Springer Medicine

Assessment of the relationship between morphological emphysema phenotype and corresponding pulmonary perfusion pattern on a segmental level

Abstract

Purpose

Material/Methods

Results

Conclusion

Key points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Material/Methods

Results

Conclusion

Key points

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