支气管壁T2w MRI信号作为重度哮喘新的影像学生物标志物。

IF 4.1 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Insights into Imaging Pub Date : 2025-03-25 DOI:10.1186/s13244-025-01939-1

Ilyes Benlala, Gaël Dournes, Pierre-Olivier Girodet, François Laurent, Wadie Ben Hassen, Fabien Baldacci, Baudouin Denis De Senneville, Patrick Berger

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They also have had pulmonary function tests (PFTs), fractional exhaled nitric oxide (FeNO) and blood eosinophils count (Eos). Comparisons between the two groups were performed using Student's t-test. Correlations were assessed using Pearson coefficients. Reproducibility was assessed using intraclass correlation coefficient and Bland-Altman analysis.Results: BrWall_T2-MIS was higher in severe than in non-severe asthma patients (74 ± 12 vs 49 ± 14; respectively p < 0.001). BrWall_T2-MIS showed a moderate inverse correlation with PFTs in the whole cohort (r = -0.54, r = -0.44 for FEV1(%pred) and FEV1/FVC respectively, p ≤ 0.01) and in the severe asthma group (r = -0.53, r = -0.44 for FEV1(%pred) and FEV1/FVC respectively, p ≤ 0.01). Eos was moderately correlated with BrWall_T2-MIS in severe asthma group (r = 0.52, p = 0.047). 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引用次数: 0

摘要

目的：重症哮喘患者容易出现严重恶化，需要住院治疗，增加了医疗保健系统的经济负担。T2w肺部MRI可用于支气管炎症的评估。本研究的主要目的是比较重症和非重症哮喘患者的定量MRI T2信号支气管强度。方法：这是一项前瞻性单中心研究（NCT03089346）的辅助研究。我们评估了15例重度哮喘患者和15例年龄和性别匹配的非重度哮喘患者的支气管壁区平均T2强度MRI信号（BrWall_T2-MIS）。他们还进行了肺功能测试（pft）、呼出一氧化氮分数（FeNO）和血液嗜酸性粒细胞计数（Eos）。两组间比较采用学生t检验。使用Pearson系数评估相关性。用类内相关系数和Bland-Altman分析评价再现性。结果：重度哮喘患者BrWall_T2-MIS高于非重度哮喘患者(74±12 vs 49±14；结论：支气管壁T2w信号强度的量化可以区分哮喘的严重程度和非严重程度，并与哮喘患者的阻塞性pft参数和炎症标志物相关。关键相关声明：在当前的生物治疗时代，非电离成像生物标志物的发展可能在严重哮喘患者的管理中发挥重要作用。重点：严重哮喘表现为严重恶化，给卫生保健系统带来沉重负担。T2w支气管壁信号强度与重度哮喘炎症标志物相关。T2w MRI可能是一种非侵入性的随访重度哮喘患者的工具。

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Bronchial wall T2w MRI signal as a new imaging biomarker of severe asthma.

Objectives: Severe asthma patients are prone to severe exacerbations with a need of hospital admission increasing the economic burden on healthcare systems. T2w lung MRI was found to be useful in the assessment of bronchial inflammation. The main goal of this study is to compare quantitative MRI T2 signal bronchial intensity between patients with severe and non-severe asthma.

Methods: This is an ancillary study of a prospective single-center study (NCT03089346). We assessed the mean T2 intensity MRI signal of the bronchial wall area (BrWall_T2-MIS) in 15 severe and 15 age and sex-matched non-severe asthmatic patients. They also have had pulmonary function tests (PFTs), fractional exhaled nitric oxide (FeNO) and blood eosinophils count (Eos). Comparisons between the two groups were performed using Student's t-test. Correlations were assessed using Pearson coefficients. Reproducibility was assessed using intraclass correlation coefficient and Bland-Altman analysis.

Results: BrWall_T2-MIS was higher in severe than in non-severe asthma patients (74 ± 12 vs 49 ± 14; respectively p < 0.001). BrWall_T2-MIS showed a moderate inverse correlation with PFTs in the whole cohort (r = -0.54, r = -0.44 for FEV1(%pred) and FEV1/FVC respectively, p ≤ 0.01) and in the severe asthma group (r = -0.53, r = -0.44 for FEV1(%pred) and FEV1/FVC respectively, p ≤ 0.01). Eos was moderately correlated with BrWall_T2-MIS in severe asthma group (r = 0.52, p = 0.047). Reproducibility was almost perfect with ICC = 0.99 and mean difference in Bland-Altman analysis of -0.15 [95% CI = -0.48-0.16].

Conclusion: Quantification of bronchial wall T2w signal intensity appears to be able to differentiate severe from non-severe asthma and correlates with obstructive PFTs' parameters and inflammatory markers in severe asthma.

Critical relevance statement: The development of non-ionizing imaging biomarkers could play an essential role in the management of patients with severe asthma in the current era of biological therapies.

Key points: Severe asthma exhibits severe exacerbations with a high burden on healthcare systems. T2w bronchial wall signal intensity is related to inflammatory biomarker in severe asthma. T2w MRI may represent a non-invasive tool to follow up severe asthma patients.

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来源期刊

Insights into Imaging Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

7.30

自引率

4.30%

发文量

182

审稿时长

13 weeks

期刊介绍： Insights into Imaging (I³) is a peer-reviewed open access journal published under the brand SpringerOpen. All content published in the journal is freely available online to anyone, anywhere! I³ continuously updates scientific knowledge and progress in best-practice standards in radiology through the publication of original articles and state-of-the-art reviews and opinions, along with recommendations and statements from the leading radiological societies in Europe. Founded by the European Society of Radiology (ESR), I³ creates a platform for educational material, guidelines and recommendations, and a forum for topics of controversy. A balanced combination of review articles, original papers, short communications from European radiological congresses and information on society matters makes I³ an indispensable source for current information in this field. I³ is owned by the ESR, however authors retain copyright to their article according to the Creative Commons Attribution License (see Copyright and License Agreement). All articles can be read, redistributed and reused for free, as long as the author of the original work is cited properly. The open access fees (article-processing charges) for this journal are kindly sponsored by ESR for all Members. The journal went open access in 2012, which means that all articles published since then are freely available online.