Magnetic resonance assessment of parenchymal elasticity in normal and edematous, ventilator-injured lung

Author:

McGee Kiaran P.1,Mariappan Yogesh K.1,Hubmayr Rolf D.23,Carter Rickey E.4,Bao Zhonghao5,Levin David L.1,Manduca Armando3,Ehman Richard L.1

Affiliation:

1. Department of Radiology, Mayo Clinic and Foundation, Rochester, Minnesota;

2. Pulmonary and Critical Care Medicine, Mayo Clinic and Foundation, Rochester, Minnesota;

3. Physiology and Biomedical Engineering, Mayo Clinic and Foundation, Rochester, Minnesota

4. Health Sciences Research, Mayo Clinic and Foundation, Rochester, Minnesota;

5. Information Technology, Mayo Clinic and Foundation, Rochester, Minnesota; and

Abstract

Magnetic resonance elastography (MRE) is a MR imaging method capable of spatially resolving the intrinsic mechanical properties of normal lung parenchyma. We tested the hypothesis that the mechanical properties of edematous lung exhibit local properties similar to those of a fluid-filled lung at transpulmonary pressures (Ptp) up to 25 cm H2O. Pulmonary edema was induced in anesthetized female adult Sprague-Dawley rats by mechanical ventilation to a pressure of 40 cm H2O for ∼30 min. Prior to imaging the wet weight of each ex vivo lung set was measured. MRE, high-resolution T1-weighted spin echo and T2* gradient echo data were acquired at each Ptpfor both normal and injured ex vivo lungs. At Ptps of 6 cm H2O and greater, the shear stiffness of normal lungs was greater than injured lungs ( P ≤ 0.0003). For Ptps up to 12 cm H2O, shear stiffness was equal to 1.00, 1.07, 1.16, and 1.26 kPa for the injured and 1.31, 1.89, 2.41, and 2.93 kPa for normal lungs at 3, 6, 9, and 12 cm H2O, respectively. For injured lungs MRE magnitude signal and shear stiffness within regions of differing degrees of alveolar flooding were calculated as a function of Ptp. Differences in shear stiffness were statistically significant between groups ( P < 0.001) with regions of lower magnitude signal being stiffer than those of higher signal. These data demonstrate that when the alveolar space filling material is fluid, MRE-derived parenchymal shear stiffness of the lung decreases, and the lung becomes inherently softer compared with normal lung.

Publisher

American Physiological Society

Subject

Physiology (medical),Physiology

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2. Lung Imaging;Respiratory Monitoring in Mechanical Ventilation;2021

3. The POOR Get POORer: A Hypothesis for the Pathogenesis of Ventilator-induced Lung Injury;American Journal of Respiratory and Critical Care Medicine;2020-10-15

4. A constitutive model for lung mechanics and injury applicable to static, dynamic, and shock loading;Mechanics of Soft Materials;2020-03-02

5. Simultaneous multislice rapid magnetic resonance elastography of the liver;NMR in Biomedicine;2020-01-23

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