Zusammenfassung
Bildgebende Verfahren spielen in der Diagnostik und Therapiekontrolle pulmonaler Erkrankungen eine entscheidende Rolle. Während bisher hauptsächlich morphologische Aspekte der Lungenbildgebung im Vordergrund standen, erlauben neuere Techniken sowohl der CT als auch der MRT zusätzlich eine Funktionsbeurteilung der Lunge. Im Folgenden Artikel werden die Möglichkeiten der funktionellen CT und MRT bei Lungenerkrankungen dargestellt und ihr möglicher Stellenwert diskutiert.
Abstract
Imaging techniques are indispensable for diagnosis and follow-up of pulmonary diseases. In the past the interest was focused on morphological aspects of pulmonary tissue. With the development of novel CT and MRI techniques functional pulmonary imaging became available. In this review the value of cross sectional functional imaging in pulmonary diseases is presented and its potential clinical applications are discussed.
Key words
Multislice Computed tomography - Magnetic Resonance Imaging - Functional lung imaging - Lung ventilation - Pulmonary circulation - Pulmonary dynamics
Literatur
-
1
Lucidarme O, Grenier P A, Cadi M, Mourey-Gerosa I, Benali K, Cluzel P.
Evaluation of air trapping at CT: comparison of continuous-versus suspended-expiration CT techniques.
Radiology.
2000;
216
768-772
-
2
King G G, Muller N L, Whittall K P, Xiang Q S, Pare P D.
An analysis algorithm for measuring airway lumen and wall areas from high-resolution computed tomographic data.
Am J Respir Crit Care Med.
2000;
161
574-580
-
3
Niimi A, Matsumoto H, Amitani R, Nakano Y, Mishima M, Minakuchi M, Nishimura K, Itoh H, Izumi T.
Airway wall thickness in asthma assessed by computed tomography. Relation to clinical indices.
Am J Respir Crit Care Med.
2000;
162
1518-1523
-
4
Austin J H, Muller N L, Friedman P J, Hansell D M, Naidich D P, Remy-Jardin M, Webb W R, Zerhouni E A.
Glossary of terms for CT of the lungs: recommendations of the Nomenclature Committee of the Fleischner Society.
Radiology.
1996;
200
327-331
-
5
Worthy S A, Muller N L, Hartman T E, Swensen S J, Padley S P, Hansell D M.
Mosaic attenuation pattern on thin-section CT scans of the lung: differentiation among infiltrative lung, airway, and vascular diseases as a cause.
Radiology.
1997;
205
465-470
-
6
Stern E J, Frank M S.
Small-airway diseases of the lungs: findings at expiratory CT.
AJR Am J Roentgenol.
1994;
163
37-41
-
7
Glazer C S, Rose C S, Lynch D A.
Clinical and radiologic manifestations of hypersensitivity pneumonitis.
J Thorac Imaging.
2002;
17
261-272
-
8
Kauczor H U, Hast J, Heussel C P, Schlegel J, Mildenberger P, Thelen M.
Focal airtrapping at expiratory high-resolution CT: comparison with pulmonary function tests.
Eur Radiol.
2000;
10
1539-1546
-
9
Gotway M B, Lee E S, Reddy G P, Golden J A, Webb W R.
Low-dose, dynamic, expiratory thin-section CT of the lungs using a spiral CT scanner.
J Thorac Imaging.
2000;
15
168-172
-
10
Heussel C P, Hafner B, Lill J, Schreiber W, Thelen M, Kauczor H U.
Paired inspiratory/expiratory spiral CT and continuous respiration cine CT in the diagnosis of tracheal instability.
Eur Radiol.
2001;
11
982-989
-
11
Ley S, Kreitner K F, Fink C, Heussel C P, Borst M M, Kauczor H U.
Assessment of pulmonary hypertension by CT and MR imaging.
Eur Radiol.
2004;
14
359-368
-
12
Hiorns M P, Mayo J R.
Spiral computed tomography for acute pulmonary embolism.
Can Assoc Radiol J.
2002;
53
258-268
-
13
Winer-Muram H T, Rydberg J, Johnson M S, Tarver R D, Williams M D, Shah H, Namyslowski J, Conces D, Jennings S G, Ying J, Trerotola S O, Kopecky K K.
Suspected acute pulmonary embolism: evaluation with multi-detector row CT versus digital subtraction pulmonary arteriography.
Radiology.
2004;
233
806-815
-
14
Herzog P, Wildberger J E, Niethammer M, Schaller S, Schoepf U J.
CT perfusion imaging of the lung in pulmonary embolism.
Acad Radiol.
2003;
10
1132-1146
-
15
Foley W D, Haughton V M, Schmidt J, Wilson C R.
Xenon contrast enhancement in computed body tomography.
Radiology.
1978;
129
219-220
-
16
Bayat S, Le D uc, Porra L, Berruyer G, Nemoz C, Monfraix S, Fiedler S, Thomlinson W, Suortti P, Standertskjold-Nordenstam C G, Sovijarvi A R.
Quantitative functional lung imaging with synchrotron radiation using inhaled xenon as contrast agent.
Phys Med Biol.
2001;
46
3287-3299
-
17
Tajik J K, Chon D, Won C, Tran B Q, Hoffman E A.
Subsecond multisection CT of regional pulmonary ventilation.
Acad Radiol.
2002;
9
130-146
-
18
Hatabu H, Chen Q, Stock K W, Gefter W B, Itoh H.
Fast magnetic resonance imaging of the lung.
Eur J Radiol.
1999;
29
114-132
-
19
Fink C, Ley S, Kauczor H U.
Radiologische Diagnostik der Lungenembolie.
Radiologie up2date.
2004;
1
17-32
-
20
Fink C, Bock M, Puderbach M, Schmahl A, Delorme S.
Partially parallel three-dimensional magnetic resonance imaging for the assessment of lung perfusion-initial results.
Invest Radiol.
2003;
38
482-488
-
21
Nikolaou K, Schoenberg S O, Brix G, Goldman J P, Attenberger U, Kuehn B, Dietrich O, Reiser M F.
Quantification of pulmonary blood flow and volume in healthy volunteers by dynamic contrast-enhanced magnetic resonance imaging using a parallel imaging technique.
Invest Radiol.
2004;
39
537-545
-
22
Hatabu H, Tadamura E, Levin D L, Chen Q, Li W, Kim D, Prasad P V, Edelman R R.
Quantitative assessment of pulmonary perfusion with dynamic contrast-enhanced MRI.
Magn Reson Med.
1999;
42
1033-1038
-
23
Meaney J F, Weg J G, Chenevert T L, Stafford-Johnson D, Hamilton B H, Prince M R.
Diagnosis of pulmonary embolism with magnetic resonance angiography.
N Engl J Med.
1997;
336
1422-1427
-
24
Fink C, Puderbach M, Bock M, Lodemann K P, Zuna I, Schmahl A, Delorme S, Kauczor H U.
Regional lung perfusion: assessment with partially parallel three-dimensional MR imaging.
Radiology.
2004;
231
175-184
-
25
Amundsen T, Torheim G, Waage A, Bjermer L, Steen P A, Haraldseth O.
Perfusion magnetic resonance imaging of the lung: characterization of pneumonia and chronic obstructive pulmonary disease. A feasibility study.
J Magn Reson Imaging.
2000;
12
224-231
-
26
Ohno Y, Hatabu H, Murase K, Higashino T, Kawamitsu H, Watanabe H, Takenaka D, Fujii M, Sugimura K.
Quantitative assessment of regional pulmonary perfusion in the entire lung using three-dimensional ultrafast dynamic contrast-enhanced magnetic resonance imaging: Preliminary experience in 40 subjects.
J Magn Reson Imaging.
2004;
20
353-365
-
27
Schaefer J F, Vollmar J, Schick F, Vonthein R, Seemann M D, Aebert H, Dierkesmann R, Friedel G, Claussen C D.
Solitary pulmonary nodules: dynamic contrast-enhanced MR imaging-perfusion differences in malignant and benign lesions.
Radiology.
2004;
232
544-553
-
28
Mai V M, Berr S S.
MR perfusion imaging of pulmonary parenchyma using pulsed arterial spin labeling techniques: FAIRER and FAIR.
J Magn Reson Imaging.
1999;
9
483-487
-
29
Rominger M B, Dinkel H P, Bachmann G F.
Comparison between fast MR flow quantification in breathhold technique in ascending aorta and pulmonary trunc with right and left ventricular cine-MRI for the assessment of stroke volumes in healthy volunteers.
Rofo.
2002;
174
196-201
-
30
Lotz J, Meier C, Leppert A, Galanski M.
Cardiovascular flow measurement with phase-contrast MR imaging: basic facts and implementation.
Radiographics.
2002;
22
651-671
-
31
Ley S, Kreitner K F, Morgenstern I, Thelen M, Kauczor H U.
Bronchopulmonary shunts in patients with chronic thromboembolic pulmonary hypertension: evaluation with helical CT and MR imaging.
AJR Am J Roentgenol.
2002;
179
1209-1215
-
32
Suga K, Tsukuda T, Awaya H, Takano K, Koike S, Matsunaga N, Sugi K, Esato K.
Impaired respiratory mechanics in pulmonary emphysema: evaluation with dynamic breathing MRI.
J Magn Reson Imaging.
1999;
10
510-520
-
33
Plathow C, Ley S, Fink C, Puderbach M, Heilmann M, Zuna I, Kauczor H U.
Evaluation of chest motion and volumetry during the breathing cycle by dynamic MRI in healthy subjects: comparison with pulmonary function tests.
Invest Radiol.
2004;
39
202-209
-
34
Montgomery A B, Paajanen H, Brasch R C, Murray J F.
Aerosolized gadolinium-DTPA enhances the magnetic resonance signal of extravascular lung water.
Invest Radiol.
1987;
22
377-381
-
35
Haage P, Karaagac S, Spuntrup E, Adam G, Gunther R W.
MR-Bildgebung der Lungenventilation mittels aerosolierter Gadolinium-Chelate.
Rofo.
2003;
175
187-193
-
36
Edelman R R, Hatabu H, Tadamura E, Li W, Prasad P V.
Noninvasive assessment of regional ventilation in the human lung using oxygen-enhanced magnetic resonance imaging.
Nat Med.
1996;
2
1236-1239
-
37
Loffler R, Muller C J, Peller M, Penzkofer H, Deimling M, Schwaiblmair M, Scheidler J, Reiser M.
Optimization and evaluation of the signal intensity change in multisection oxygen-enhanced MR lung imaging.
Magn Reson Med.
2000;
43
860-866
-
38
Nakagawa T, Sakuma H, Murashima S, Ishida N, Matsumura K, Takeda K.
Pulmonary ventilation-perfusion MR imaging in clinical patients.
J Magn Reson Imaging.
2001;
14
419-424
-
39
Muller C J, Schwaiblmair M, Scheidler J, Deimling M, Weber J, Loffler R B, Reiser M F.
Pulmonary diffusing capacity: assessment with oxygen-enhanced lung MR imaging preliminary findings.
Radiology.
2002;
222
499-506
-
40
Ohno Y, Hatabu H, Takenaka D, van Cauteren M, Fujii M, Sugimura K.
Dynamic oxygen-enhanced MRI reflects diffusing capacity of the lung.
Magn Reson Med.
2002;
47
1139-1144
-
41
Jakob P M, Wang T, Schultz G, Hebestreit H, Hebestreit A, Hahn D.
Assessment of human pulmonary function using oxygen-enhanced T1 imaging in patients with cystic fibrosis.
Magn Reson Med.
2004;
51
1009-1016
-
42
Albert M S, Cates G D, Driehuys B, Happer W, Saam B, Springer C S , Wishnia A.
Biological magnetic resonance imaging using laser-polarized 129Xe.
Nature.
1994;
370
199-201
-
43
Kauczor H U, Ebert M, Kreitner K F, Nilgens H, Surkau R, Heil W, Hofmann D, Otten E W, Thelen M.
Imaging of the lungs using 3He MRI: preliminary clinical experience in 18 patients with and without lung disease.
J Magn Reson Imaging.
1997;
7
538-543
-
44
Schreiber W G, Weiler N, Kauczor H U, Markstaller K, Eberle B, Hast J, Surkau R, Grossmann T, Deninger A, Hanisch G, Otten E W, Thelen M.
Ultrafast MRI of lung ventilation using hyperpolarized helium-3.
Rofo.
2000;
172
129-133
-
45
Lehmann F, Knitz F, Weiler N, Gast K K, Ley S, Schmiedeskamp J, Heussel C P, Bellemann M E, Kauczor H U, Schreiber W G.
A Software Tool for Analysis and Quantification of Regional Pulmonary Ventilation Using Dynamic Hyperpolarised-3He-MRI.
Rofo.
2004;
176
1399-1408
-
46
Ley S, Zaporozhan J, Morbach A, Eberle B, Gast K K, Heussel C P, Biedermann A, Mayer E, Schmiedeskamp J, Stepniak A, Schreiber W G, Kauczor H U.
Functional evaluation of emphysema using diffusion-weighted 3Helium-magnetic resonance imaging, high-resolution computed tomography, and lung function tests.
Invest Radiol.
2004;
39
427-434
-
47
Fedullo P F, Tapson V F.
Clinical practice. The evaluation of suspected pulmonary embolism.
N Engl J Med.
2003;
349
1247-1256
Dr. Michael Puderbach
Deutsches Krebsforschungszentrum, Abteilung Radiologie (E010), Innovative Krebsdiagnostik und Therapie
Im Neuenheimer Feld 280 · 69120 Heidelberg
Phone: 06221 42-2525, -2521
Fax: 06221 42-2531
Email: m.puderbach@dkfz-heidelberg.de
