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Emphysema: Hyperpolarized Helium 3 Diffusion MR Imaging of the Lungs Compared with Spirometric Indexes—Initial Experience¹

¹ From the Center for In-vivo Hyperpolarized Gas MR Imaging, Departments of Radiology (M.S., E.E.d.L., T.A.A., J.R.B., J.P.M.), Biomedical Engineering (M.S., T.A.A., J.R.B., J.P.M.), and Internal Medicine (J.D.T.), University of Virginia School of Medicine, 1000 Lee St, Box 800170, Charlottesville, VA 22908. From the 2000 RSNA scientific assembly. Received November 24, 2000; revision requested January 22, 2001; revision received April 23; accepted May 15. Supported in part by National Institutes of Health grant R44-HL059022; the University of Virginia Pratt Fund; the Dean of the Medical School, Robert M. Carey, MD; and Siemens Medical Solutions, Iselin, NJ. Address correspondence to J.P.M. (e-mail: jpm7r@virginia.edu).

PURPOSE: To quantitatively evaluate hyperpolarized helium 3 (³He) diffusion magnetic resonance (MR) images of the lung in patients with emphysema and to determine whether apparent diffusion coefficients (ADCs) measured with MR imaging correlate with spirometric indexes.

MATERIALS AND METHODS: Hyperpolarized ³He diffusion MR imaging was performed in 16 healthy volunteers and 11 patients. Coronal diffusion-sensitized MR images were obtained during suspended respiration after inhalation of laser-polarized ³He gas, and images of the ADC were calculated. Spirometry was performed immediately before imaging. The mean and SD of the ADCs were compared between subject groups and were correlated with spirometric indexes.

RESULTS: ADC images were homogeneous in volunteers, but demonstrated regional variations in patients. The mean and SD of the ADCs for patients were significantly larger (P < .002) than those for volunteers. The mean ADCs for all subjects correlated with the percentage of predicted forced expiratory volume in 1 second, or FEV₁, (r = -0.797, P < .001) and the ratio of FEV₁ to forced vital capacity, or FVC, (r = -0.930, P < .001). ADC images in patients demonstrated a significant increase (P < .001) in the ADCs in the upper regions compared with the lower regions of the lung.

CONCLUSION: Hyperpolarized ³He diffusion MR imaging demonstrated potential for use in evaluating the global and regional severity of emphysema.

Index terms: Alpha-1–antitrypsin deficiency, 60.7511 • Emphysema, pulmonary, 60.751 • Helium • Lung, MR, 60.12143 • Magnetic resonance (MR), contrast enhancement, 60.121412, 61.12143 • Magnetic resonance (MR), nuclei other than H, 60.121412, 60.12147

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