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Phenotyping bronchopulmonary dysplasia using magnetic resonance imaging
Samal Munidasa1, Paul S Kingma2, Jason C Woods3
1Pulmonary Medicine, Cincinnati Children's Hospital, 3333 Burnet Ave, Cincinnati, OH 45229, USA.
Insights
Bronchopulmonary dysplasia (BPD) involves lung, airway, and vascular issues. Advanced MRI imaging helps assess these BPD phenotypes for better infant care.
Area of Science:
- Neonatal Medicine
- Pediatric Pulmonology
- Medical Imaging
Background:
- Bronchopulmonary dysplasia (BPD) is a chronic lung disease in premature infants, marked by impaired lung development and ongoing respiratory problems.
- BPD presents with three main phenotypes: parenchymal lung disease (affecting alveoli and gas exchange), airway disease (causing obstruction), and pulmonary vascular disease (leading to pulmonary hypertension).
- These phenotypes can occur independently or concurrently, complicating patient management.
Purpose of the Study:
- To highlight the role of advanced Magnetic Resonance Imaging (MRI) techniques in evaluating the distinct phenotypes of Bronchopulmonary dysplasia (BPD).
- To demonstrate how MRI can provide non-invasive assessments of lung structure, function, and vasculature in infants with BPD.
- To underscore the potential of imaging-based phenotyping for improved disease monitoring, risk stratification, and personalized treatment strategies in BPD.
Main Methods:
- Review of advanced MRI techniques applicable to BPD phenotyping.
- Description of MRI's capability to assess lung structure (alveolar growth, emphysema), airway dynamics (malacia, stenosis), and pulmonary vasculature (remodeling, resistance).
- Discussion of MRI's role in evaluating cardiac function (ventricular morphology and function) associated with pulmonary hypertension in BPD.
Main Results:
- Advanced MRI enables comprehensive, non-invasive assessment of BPD's parenchymal, airway, and vascular components.
- MRI can evaluate lung structure, ventilation, perfusion, airway abnormalities, vascular remodeling, and cardiac function.
- Imaging-based phenotyping offers detailed insights into disease complexity and progression.
Conclusions:
- Advanced MRI is a powerful tool for characterizing the multifaceted phenotypes of Bronchopulmonary dysplasia (BPD).
- Non-invasive imaging facilitates a deeper understanding of BPD's impact on lung development, airways, and pulmonary vasculature.
- Imaging-based phenotyping holds significant promise for tailoring management and improving outcomes for infants with BPD.
Abstract:
Bronchopulmonary dysplasia (BPD) is characterized by impaired lung development and persistent respiratory morbidity. BPD comprises three primary phenotypes: parenchymal, airway, and pulmonary vascular disease. Parenchymal disease involves disrupted alveolar growth, emphysema, hyperinflation, inflammation, and fibrosis, leading to impaired gas exchange. Airway disease, including airway malacia and subglottic stenosis, causes airflow obstruction and increased work of breathing. Pulmonary vascular disease involves abnormal vascular remodeling and increased pulmonary vascular resistance, which contributes to the development of pulmonary hypertension. Imaging plays a central role in evaluating these phenotypes which may occur independently or overlap with other phenotypes. Advanced MRI techniques enable non-invasive assessment of lung structure, ventilation, perfusion, airway shape and dynamics, vascular remodeling, and ventricular morphology and function. Imaging-based phenotyping can enhance disease monitoring, risk stratification, and help to inform personalized management strategies in infants with BPD.
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