Publication related to RSI or an RSI staff member
Pulmonary Magnetic Resonance Imaging of Ex-Preterm Children with and without Bronchopulmonary Dysplasia.
Rationale: Children born prematurely, particularly those with bronchopulmonary dysplasia, have persisting lung abnormalities requiring longitudinal monitoring. Pulmonary ultrashort echo time magnetic resonance imaging (MRI) measurements may provide sensitive markers of persisting lung abnormalities and have not been evaluated in school-aged children born prematurely. Objectives: To compare pulmonary MRI and pulmonary function test measurements in preterm-born school-aged children with and without bronchopulmonary dysplasia. Methods: Children aged 7-9 years, born extremely preterm, with and without bronchopulmonary dysplasia, were recruited from three centers. Participants underwent pulmonary ultrashort echo time MRI and pulmonary function tests. Primary outcomes included total proton density and proton density at full expiration, measured using MRI. Multiple linear regression analysis was performed, adjusting for gestational age and bronchopulmonary dysplasia. Associations between MRI and pulmonary function were tested. Results: Thirty-five children were included in the primary analysis (24 with bronchopulmonary dysplasia, 11 without); 29 completed pulmonary function tests, of whom 11 (38%) had airflow limitation. Children with bronchopulmonary dysplasia had 44% (95% confidence interval [CI], 10-66%) lower mean total proton density (mean +/- standard deviation, 3.6 +/- 2.6) than those without (6.1 +/- 4.0). Those with bronchopulmonary dysplasia had 25% (95% CI, 3-42%) lower proton density at full expiration than those without. Lower total proton density and proton density at full expiration were moderately correlated with greater residual volume, residual volume/total lung capacity, and lung clearance index (Spearman correlations for total proton density: -0.42, -0.57, and -0.53, respectively. Spearman correlations for proton density at full expiration: -0.28, -0.57, and -0.45, respectively). Conclusions: School-aged preterm-born children with bronchopulmonary dysplasia have parenchymal tissue abnormalities measured using ultrashort MRI proton density, compared with those without. MRI proton density correlated with pulmonary function measures indicative of gas trapping. Clinical trial registered with www.clinicaltrials.gov (NCT02921308).
Authors
- Katz, Sherri L, Katz SL, Department of Pediatrics, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada.; Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.
- Parraga, Grace, Parraga G, Department of Medical Biophysics, Western University, London, Ontario, Canada.; Robarts Research Institute, London, Ontario, Canada.
- Luu, Thuy Mai, Luu TM, Centre Hospitalier Universitaire Sainte-Justine, Montréal, Québec, Canada.
- Santyr, Giles, Santyr G, Department of Pediatrics, Hospital for Sick Children, and.; Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada.; Translational Medicine Program, SickKids, Toronto, Ontario, Canada.
- Abdeen, Nishard, Abdeen N, Department of Pediatrics, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada.
- Deschenes, Sylvain, Deschenes S, Centre Hospitalier Universitaire Sainte-Justine, Montréal, Québec, Canada.
- Tse, Sze Man, Tse SM, Centre Hospitalier Universitaire Sainte-Justine, Montréal, Québec, Canada.
- Couch, Marcus J, Couch MJ, Siemens Healthcare Limited, Montréal, Québec, Canada.; McConnell Brain Imaging Centre, Montreal Neurological Institute, Montréal, Québec, Canada.; Department of Neurology and Neurosurgery, McGill University, Montréal, Québec, Canada; and.
- Barrowman, Nicholas, Barrowman N, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.
- Hayawi, Lamia, Hayawi L, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.
- Momoli, Franco, Momoli F, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.
- Blinder, Henrietta, Blinder H, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.
- Thebaud, Bernard, Thebaud B, Department of Pediatrics, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada.; Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.; Regenerative Medicine Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
- Nuyt, Anne-Monique, Nuyt AM, Centre Hospitalier Universitaire Sainte-Justine, Montréal, Québec, Canada.
- Ben Fadel, Nadya, Ben Fadel N, Department of Pediatrics, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada.
- Moraes, Theo J, Moraes TJ, Department of Pediatrics, Hospital for Sick Children, and.; Translational Medicine Program, SickKids, Toronto, Ontario, Canada.
Rationale: Children born prematurely, particularly those with bronchopulmonary dysplasia, have persisting lung abnormalities requiring longitudinal monitoring. Pulmonary ultrashort echo time magnetic resonance imaging (MRI) measurements may provide sensitive markers of persisting lung abnormalities and have not been evaluated in school-aged children born prematurely. Objectives: To compare pulmonary MRI and pulmonary function test measurements in preterm-born school-aged children with and without bronchopulmonary dysplasia. Methods: Children aged 7-9 years, born extremely preterm, with and without bronchopulmonary dysplasia, were recruited from three centers. Participants underwent pulmonary ultrashort echo time MRI and pulmonary function tests. Primary outcomes included total proton density and proton density at full expiration, measured using MRI. Multiple linear regression analysis was performed, adjusting for gestational age and bronchopulmonary dysplasia. Associations between MRI and pulmonary function were tested. Results: Thirty-five children were included in the primary analysis (24 with bronchopulmonary dysplasia, 11 without); 29 completed pulmonary function tests, of whom 11 (38%) had airflow limitation. Children with bronchopulmonary dysplasia had 44% (95% confidence interval [CI], 10-66%) lower mean total proton density (mean +/- standard deviation, 3.6 +/- 2.6) than those without (6.1 +/- 4.0). Those with bronchopulmonary dysplasia had 25% (95% CI, 3-42%) lower proton density at full expiration than those without. Lower total proton density and proton density at full expiration were moderately correlated with greater residual volume, residual volume/total lung capacity, and lung clearance index (Spearman correlations for total proton density: -0.42, -0.57, and -0.53, respectively. Spearman correlations for proton density at full expiration: -0.28, -0.57, and -0.45, respectively). Conclusions: School-aged preterm-born children with bronchopulmonary dysplasia have parenchymal tissue abnormalities measured using ultrashort MRI proton density, compared with those without. MRI proton density correlated with pulmonary function measures indicative of gas trapping. Clinical trial registered with www.clinicaltrials.gov (NCT02921308).
