Related Experiment Video
Updated: Jun 26, 2025
Multi-modal Pulmonary Imaging: Using Complementary Information from CT and Hyperpolarized 129Xe MRI to Evaluate Lung Structure-Function
Published on: April 12, 2024
Virtual Growing Child (VGC): A general normative comparative system via quantitative dynamic MRI for quantifying
Insights
A new database quantifies regional respiratory function in healthy children, revealing sex-based differences during adolescence. This system aids in assessing respiratory conditions and treatment effectiveness in pediatric patients.
Area of Science:
- * Pulmonary imaging and quantitative analysis
- * Pediatric respiratory physiology
- * Biomedical informatics
Background:
- * Lack of a normative database for regional respiratory structure and function in healthy children.
- * Need for objective measures to assess respiratory abnormalities in pediatric patients.
Approach:
- * Development of the Ventilation-Perfusion (VGC) database with 3,820 3D segmentations.
- * Analysis of morphological, architectural, dynamic, and developmental respiratory parameters.
- * Comparison of healthy children across age and gender groups using two-sided t-testing and Mahalanobis distance.
Key Points:
- * Identified sex-based physiological differences in lung and diaphragm tidal volumes during adolescence (10-12 years).
- * Demonstrated significant improvement in left-sided respiratory function (diaphragm height, tidal volume) post-surgery in Tracheoesophageal Fistula with Esophageal Atresia (TIS) patients.
- * Showed reduced Mahalanobis distance for TIS patients post-surgery, indicating closer proximity to normative values.
Conclusions:
- * The VGC system establishes a reference standard for quantifying regional respiratory abnormalities in pediatric patients.
- * Facilitates treatment planning and assessment of treatment response for various pediatric respiratory conditions using diffusion MRI (dMRI).
Background:
A normative database of regional respiratory structure and function in healthy children does not exist.
Methods:
VGC provides a database with four categories of regional respiratory measurement parameters including morphological, architectural, dynamic, and developmental. The database has 3,820 3D segmentations (around 100,000 2D slices with segmentations). Age and gender group analysis and comparisons for healthy children were performed using those parameters via two-sided t-testing to compare mean measurements, for left and right sides at end-inspiration (EI) and end-expiration (EE), for different age and gender specific groups. We also apply VGC measurements for comparison with TIS patients via an extrapolation approach to estimate the association between measurement and age via a linear model and to predict measurements for TIS patients. Furthermore, we check the Mahalanobis distance between TIS patients and healthy children of corresponding age.
Findings:
The difference between male and female groups (10-12 years) behave differently from that in other age groups which is consistent with physiology/natural growth behavior related to adolescence with higher right lung and right diaphragm tidal volumes for females(p<0.05). The comparison of TIS patients before and after surgery show that the right and left components are not symmetrical, and the left side diaphragm height and tidal volume has been significantly improved after surgery (p <0.05). The left lung volume at EE, and left diaphragm height at EI of TIS patients after surgery are closer to the normal children with a significant smaller Mahalanobis distance (MD) after surgery (p<0.05).
Interpretation:
The VGC system can serve as a reference standard to quantify regional respiratory abnormalities on dMRI in young patients with various respiratory conditions and facilitate treatment planning and response assessment.
Funding:
The grant R01HL150147 from the National Institutes of Health (PI Udupa).
Related Concept Videos
01:27Physical Assessment of the Respiratory Tract II: Inspection
Chest Configuration
The chest configuration...
01:30Respiratory System Abnormal Finding I: Inspection and Percussion
Inspection Findings
During an inspection, several findings may suggest the presence of respiratory distress or disease. Pursed-lip breathing, where exhalation is slowed by...
01:30Assessment of Airway, Skin Color, and Use of Accessory Muscles
Introduction
The initial evaluation of a patient's respiratory system...