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Asthma

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MRI of the Lung

Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

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Abstract

Asthma is a disease with significant clinical impact and growing incidence, particularly in children. The disease is characterized by a complex interplay of environmental and genetic factors that affect airway structure and function leading to persistent and spatially heterogeneous airway obstruction. Conventional methods for evaluating lung function using spirometry and plethysmography are not capable of assessing regional obstruction nor the regional dynamics of airway obstruction. Imaging methods have emerged as an attractive approach to evaluate heterogeneity and mechanisms of airway obstruction in the asthmatic lung. Specifically, hyperpolarized (HP) helium-3 (He-3) MRI has enabled visualization of the airspaces of the lungs, including the large airways and lung parenchyma, during breath-held and dynamic respiratory maneuvers. This method has been applied to study asthma phenotypes, disease progression, and response to interventions with methacholine and therapy. The number and size of ventilation defects correlate with disease severity and with spirometric measures, principally FEV1 percent predicted. More importantly, regional patterns of obstruction observed on HP He-3 MRI identify regions of persistent ventilation defects that may reflect underlying structural changes in the airways such as remodeling or chronic inflammation. Multi-modality comparisons between multi-detector computed tomography (MDCT) and emerging quantitative measures using proton and HP He-3 MRI will help evaluate regional structure-function relationships to assess causal mechanisms of disease and response to therapy.

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Authors and Affiliations

  1. Departments of Medical Physics and Radiology, University Wisconsin Medical School, 600 Highland Avenue, 53792, Madison, WI, USA

    Sean B. Fain

  2. Department of Medical Physics, J5/M158 Clinical Science Center, 600 Highland Avenue, 53792, Madison, WI, USA

    James H. Holmes

  3. School of Pharmacy and Morris Institute for Respiratory Research, 600 Highland Avenue, 53792, Madison, WI, USA

    Ronald L. Sorkness

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  1. Sean B. Fain
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  2. James H. Holmes
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  3. Ronald L. Sorkness
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Editors and Affiliations

  1. Diagnostic and Interventional Radiology, University Clinic Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany

    Hans-Ulrich Kauczor

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Fain, S., Holmes, J., Sorkness, R. (2009). Asthma. In: Kauczor, HU. (eds) MRI of the Lung. Medical Radiology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-34619-7_8

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  • DOI: https://doi.org/10.1007/978-3-540-34619-7_8

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