• Chest · Feb 2021

    Thoracic quantitative dynamic MRI to understand developmental changes in normal ventilatory dynamics.

    • Yubing Tong, Jayaram K Udupa, Joseph M McDonough, Caiyun Wu, Changjian Sun, Catherine Qiu, Carina Lott, Nirupa Galagedera, Jason B Anari, Oscar H Mayer, Drew A Torigian, and Patrick J Cahill.
    • Medical Image Processing Group, Department of Radiology, University of Pennsylvania, Philadelphia, PA.
    • Chest. 2021 Feb 1; 159 (2): 712-723.

    BackgroundA database of normative quantitative measures of regional thoracic ventilatory dynamics, which is essential to understanding better thoracic growth and function in children, does not exist.Research QuestionHow to quantify changes in the components of ventilatory pump dynamics during childhood via thoracic quantitative dynamic MRI (QdMRI)?Study Design And MethodsVolumetric parameters were derived via 51 dynamic MRI scans for left and right lungs, hemidiaphragms, and hemichest walls during tidal breathing. Volume-based symmetry and functional coefficients were defined to compare left and right sides and to compare contributions of the hemidiaphragms and hemichest walls with tidal volumes (TVs). Statistical analyses were performed to compare volume components among four age-based groups.ResultsRight thoracic components were significantly larger than left thoracic components, with average ratios of 1.56 (95% CI, 1.41-1.70) for lung TV, 1.81 (95% CI, 1.60-2.03) for hemidiaphragm excursion TV, and 1.34 (95% CI, 1.21-1.47) for hemichest wall excursion TV. Right and left lung volumes at end-expiration showed, respectively, a 44% and 48% increase from group 2 (8 ≤ age < 10) to group 3 (10 ≤ age < 12). These numbers from group 3 to group 4 (12 ≤ age ≤ 14) were 24% and 28%, respectively. Right and left hemichest wall TVs exhibited, respectively, 48% and 45% increases from group 3 to group 4.InterpretationNormal right and left ventilatory volume components have considerable asymmetry in morphologic features and dynamics and change with age. Chest wall and diaphragm contributions vary in a likewise manner. Thoracic QdMRI can provide quantitative data to characterize the regional function and growth of the thorax as it relates to ventilation.Copyright © 2020 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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