Meeting Banner
Abstract #1358

Direct Imaging of Delayed and Collateral Ventilation in COPD Using Hyperpolarised 3He MRI

Helen Marshall1, Martin H. Deppe1, Juan Parra-Robles1, Sue Hillis2, Catherine Billings2, Smitha Rajaram1, Andrew J. Swift1, Sam R. Miller3, Joanna H. Watson3, Jan Wolber4, David A. Lipson5, Rod Lawson2, Jim M. Wild1

1Academic Radiology, University of Sheffield, Sheffield, South Yorkshire, United Kingdom; 2Respiratory Medicine, Sheffield Teaching Hospitals NHS Trust; 3GlaxoSmithKline, Stockley Park; 4GE Healthcare, Amersham; 5GlaxoSmithKline, King of Prussia

Collateral ventilation is an important mechanism in Chronic Obstructive Pulmonary Disease but limited observations of it have been demonstrated in vivo. 10 COPD patients were scanned with hyperpolarised. 3He MRI using a time-resolved 3D sequence. 3He was observed moving into lung regions which were initially non-ventilated during a static breath-hold. The images show direct visual evidence of delayed gas ventilation in what we believe to be collateral ventilation in COPD. Delayed-filling of peripheral regions was also observed in some patients which may be due to increased flow resistance in the small airways.

Keywords

able academic airways allowing alone amplified appearing arrows believe billings body breath breathing bronchi capable chronic clinical coil collateral consistent coronal course coverage cycles decay defect defects defined delayed diffusion diffusive diminishes direct directly disease edge edges eight entering example examples expected faster feeding flow front full funded gold gradually guidelines hold hospitals imply important in vivo indicated indirect infer influx inhaled initially intern invest king kingdom likely limited long lung martin mechanism mechanisms medicine miller moderate monitoring much natural normally observations obstruction obstructive oxygen park partial pathways patients pattern period peripheral physiology place positioned potentially presence pressure procedure processes progressing progressive pulmonary pure radiation radiology receive related renewable require resistance resolution respiratory scanned scanning sensitive session severe slow slowly solutions south strongest subtle suggesting support swift system taking teaching thorax towards transmit trapping treatment trust varied ventilated ventilation vest voids volume wash whole wild xenon