Lung structure and function on MRI in preterm born school children with and without BPD: A feasibility study

Area of Science:

• Pediatric Pulmonology
• Medical Imaging
• Neonatology

Background:

• Bronchopulmonary dysplasia (BPD) is a common respiratory complication of prematurity, causing structural lung changes and impaired respiratory outcomes.
• Preterm children without BPD can also experience similar adverse respiratory outcomes.
• A safe imaging modality is needed for assessing disease severity and risk stratification in preterm children with and without BPD.

Purpose of the Study:

• To develop a magnetic resonance imaging (MRI) protocol for evaluating preterm children with and without BPD at school age.
• To assess structural and functional lung damage using MRI.
• To correlate MRI findings with spirometry results.

Main Methods:

• MRI scans were performed on healthy volunteers, preterm children with BPD, and preterm children without BPD (median age range: 8.8-15.6 years).
• Images were analyzed for abnormalities, bronchopathy, and architectural distortion.
• Ventilation and perfusion defects were assessed using Fourier Decomposition (FD) MRI and correlated with spirometry.

Main Results:

• Children with BPD showed significantly higher percentages of diseased lung on MRI compared to preterm children without BPD and healthy controls.
• The percentage of diseased lung correlated negatively with key spirometry measures, including FEV1, FEV1/FVC, and FEF75.
• Ventilation and perfusion defects identified by FD MRI corresponded to hypointense regions on expiratory MRI.

Conclusions:

• Chest MRI is a sensitive and safe imaging method for identifying structural and functional lung damage in school-aged preterm children, with or without BPD.
• MRI findings correlate well with spirometry, providing valuable insights into respiratory health.
• The proposed MRI protocol, free from ionizing radiation, contrast agents, and anesthesia, is suitable for the long-term follow-up of preterm children.