Functional magnetic resonance imaging to identify COVID lung lesions that are not visible to computed tomography

Xenon 129 functional MRI is able to identify lung abnormalities that cannot be detected by CT scans in patients with COVID-19 long after hospitalization, even in those who have not been hospitalized. A new study published in the journal Radiology explains this work.

a An English-language study published in the journal Revue Radiology It is proposed to determine whether the pulmonary abnormalities described on functional magnetic resonance imaging by inhalation of hyperpolarized gas in posthospital COVID-19 patients were also present in contaminated but not hospitalized patients.

Xenon 129 Functional Inhaled MRI Promises CT Results in Some Cases

The lead author of the study, Dr. Fergus Gleeson is from the Department of Oncology at the University of Oxford and the Department of Radiology at the Oxford University Hospitals NHS Trust. These abnormalities do not appear on conventional imaging, and have been detected in some individuals for up to a year after initial infection with COVID-19. »

Hp-XeMRI showed promising results in detecting abnormalities of alveolar gas exchange even when computerized tomography (CT) scans and lung function tests were normal. It allows assessment of ventilation and gas exchange in red blood cells and provides regional information on the integrity of the pulmonary vasculature.

Explorations of Hp-XeMRI on Patients with Long-Term COVID-19 in Hospital or Not

In the case of prolonged COVID-19 disease, respiratory pattern disturbance is commonly identified and contributes to shortness of breath in a significant proportion of patients. However, it is not known if there are other causes for their shortness of breath. “The use of Hp-XeMRI allows us to understand the cause of shortness of breath in patients who have been suffering from COVID for a long time and to suggest better treatments to improve these symptoms,” continues study co-author Professor James T. Clinical Research Center and NHS Trust Department of Radiology, Oxford University Hospitals.

For this prospective study, the researchers attempted to determine whether lung abnormalities previously described on Hp-XeMRI in participants after hospitalization with COVID-19 were also present in non-hospitalized participants with prolonged COVID-19. 11 participants were enrolled in prolonged COVID (NHLC) and 12 post-hospital (PHC) participants from June 2020 to August 2021. All participants had symptoms of shortness of breath. As a control group, healthy volunteers with no evidence of previous COVID-19 infection were recruited from staff at the University of Sheffield and the University of Oxford.

Work should be extended to other groups of lung diseases

Participants underwent a chest CT scan, Hp-XeMRI tests, and lung function tests, among others. Control subjects underwent Hp-XeMRI only. CT scans were analyzed to determine the severity of lung disease after COVID using the FAN grading system. The analysis used group and pairwise comparisons between participants and controls, and correlations between participants’ clinical and imaging data. Both NHLC and PHC participants underwent normal or near-normal CT scans.

“We saw that the ability of gas to move from the lungs into the bloodstream was lower in non-hospitalized patients compared to those who were hospitalized with COVID,” Dr. Gleeson continues. Furthermore, both groups of participants had Hp-XeMRI values. lower than healthy participants, indicating possible defects in the lining of the lungs or surrounding blood vessels.The results showed significant differences in the mean ratio of red blood cells to tissue plasma between healthy controls and primary care/NHLC participants, indicating that Possible differences in lung function.

“In an upcoming study, we will evaluate different groups of participants who have had COVID and correlate the results with physiological data, symptom-based questionnaire and cardiac MRI to better understand the clinical significance of our findings. Dr. Gleeson. Further work will also be conducted to determine the nature of the defect, which will allow We then determine if specific treatments are beneficial.”

Bruno Pinky with RSNA

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