Use of Hyperpolarized 129Xe MR Lung Imaging in Infants
Children's Hospital Medical Center, Cincinnati
Summary
Abnormalities of the lungs are common in newborns and can include aspiration or infectious pneumonia, respiratory distress syndrome (RDS), bronchopulmonary dysplasia (BPD), pulmonary hypertension (PH), congenital diaphragmatic hernia (CDH), and other abnormalities of lung development. Diagnostic radiography is commonly used in this population to differentiate diagnosis and to assess changes after treatment. While X-ray and CT provide quality imaging, they also expose infants to ionizing radiation. MR imaging offers a safe, non-ionizing alternative. However, imaging lungs via 1H MR is intrinsically difficult due to multiple air-tissue interfaces within the lungs causing local gradients and severe magnetic field susceptibility, which leads to an exceedingly short effective transverse relaxation time (T2\*). Additionally, the lungs have low proton density, which along with the short T2\* results in low signal to noise ratio, and the physiological motion caused by respiration and cardiac pulsation further reduces lung signal. The development of more powerful hardware, along with faster MRI techniques, has enabled detailed noninvasive 1H MR imaging of pulmonary tissues. Additionally, the development of inhaled hyperpolarized gas MRI has led to breakthroughs in the ability to visualize and quantify regional ventilation and alveolar size.
Description
MRI with hyperpolarized xenon-129 and helium-3 noble gases has been tested and utilized at CCHMC in adults and children over 4 years with a very strong safety record. The safety of both helium-3 and xenon-129 is well known, with 3He being used safely and effectively to image infants, and 129Xe being used extensively in school-age children at CCHMC and elsewhere. Upon inhalation of an anoxic gas mixture, this mixture mixes with the residual volume of standard oxygenated breathing air that remains in the lung even after a normal exhalation, yielding a hypoxic breath. This is performed in the MRI…
Eligibility
- Age range
- Up to 0 years
- Sex
- All
- Healthy volunteers
- No
All Cohorts Inclusion Criteria: * Male or female * Any age NICU inpatient who is clinically stable and with adequate temperature control to tolerate MRI as determined by the primary clinical team Cohort 1 * Age 0 - 6 months * NICU patient on oxygen with a nasal cannula (≤ 2L per minute) (unchanged - supplemental O2 for minimum 24 hours) * Maintaining SpO2 \> 88% on nasal O2 Cohort 2 * Age 0 - 6 months * NICU patient who requires a slightly higher level of respiratory support (with High Flow Nasal Cannula \> 2L per minute, CPAP, or RAM cannula and O2 unchanged for minimum 24 hours), with…
Interventions
- Drug129Xe
Inhaled contrast for MRI
Location
- Megan SchmittCincinnati, Ohio