Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
권호 표지
DOI QR코드

DOI QR Code

Collateral Ventilation to Congenital Hyperlucent Lung Lesions Assessed on Xenon-Enhanced Dynamic Dual-Energy CT: an Initial Experience

  • Goo, Hyun-Woo (Department of Radiology and the Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine,) ;
  • Yang, Dong-Hyun (Department of Radiology and the Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine,) ;
  • Kim, Nam-Kug (Department of Radiology and the Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine,) ;
  • Park, Seung-Il (Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine,) ;
  • Kim, Dong-Kwan (Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine,) ;
  • Kim, Ellen Ai-Rhan (Department of Neonatology, Asan Medical Center, University of Ulsan College of Medicine)
  • Published : 2011.02.01
⟨ Previous Next ⟩

Abstract

Objective: We wanted to evaluate the resistance to collateral ventilation in congenital hyperlucent lung lesions and to correlate that with the anatomic findings on xenon-enhanced dynamic dual-energy CT. Materials and Methods: Xenon-enhanced dynamic dual-energy CT was successfully and safely performed in eight children (median age: 5.5 years, 4 boys and 4 girls) with congenital hyperlucent lung lesions. Functional assessment of the lung lesions on the xenon map was done, including performing a time-xenon value curve analysis and assessing the amplitude of xenon enhancement (A) value, the rate of xenon enhancement (K) value and the time of arrival value. Based on the A value, the lung lesions were categorized into high or low (A value > 10 Hounsfi eld unit [HU]) resistance to collateral ventilation. In addition, the morphologic CT findings of the lung lesions, including cyst, mucocele and an accessory or incomplete fissure, were assessed on the weighted-average CT images. The xenon-enhanced CT radiation dose was estimated. Results: Five of the eight lung lesions were categorized into the high resistance group and three lesions were categorized into the low resistance group. The A and K values in the normal lung were higher than those in the low resistance group. The time of arrival values were delayed in the low resistance group. Cysts were identifi ed in fi ve lesions, mucocele in four, accessory fi ssure in three and incomplete fi ssure in two. Either cyst or an accessory fi ssure was seen in four of the fi ve lesions showing high resistance to collateral ventilation. The xenon-enhanced CT radiation dose was 2.3 ${\pm}$ 0.6 mSv. Conclusion: Xenon-enhanced dynamic dual-energy CT can help visualize and quantitate various degrees of collateral ventilation to congenital hyperlucent lung lesions in addition to assessing the anatomic details of the lung.

Keywords

References

  1. Lee EY, Boiselle PM, Cleveland RH. Multidetector CT evaluation of congenital lung anomalies. Radiology 2008;247:632-648 https://doi.org/10.1148/radiol.2473062124
  2. Chae EJ, Seo JB, Goo HW, Kim N, Song KS, Lee SD, et al. Xenon ventilation CT with a dual-energy technique of dualsource CT: initial experience. Radiology 2008;248:615-624 https://doi.org/10.1148/radiol.2482071482
  3. Goo HW, Yang DH, Hong SJ, Yu J, Kim BJ, Seo JB, et al. Xenon ventilation CT using dual-source and dual-energy technique in children with bronchiolitis obliterans: correlation of xenon and CT density values with pulmonary function test results. Pediatr Radiol 2010;40:1490-1497 https://doi.org/10.1007/s00247-010-1645-3
  4. Goo HW, Chae EJ, Seo JB, Hong SJ. Xenon ventilation CT using a dual-source dual-energy technique: dynamic ventilation abnormality in a child with bronchial atresia. Pediatr Radiol 2008;38:1113-1116 https://doi.org/10.1007/s00247-008-0914-x
  5. Chae EJ, Seo JB, Lee J, Kim N, Goo HW, Lee HJ, et al. Xenon ventilation imaging using dual-energy computed tomography in asthmatics: initial experience. Invest Radiol 2010;45:354-361
  6. Kang MJ, Park CM, Lee CH, Goo JM, Lee HJ. Dual-energy CT: clinical applications in various pulmonary diseases. Radiographics 2010;30:685-698 https://doi.org/10.1148/rg.303095101
  7. Park EA, Goo JM, Park SJ, Lee HJ, Lee CH, Park CM, et al. Chronic obstructive pulmonary disease: quantitative and visual ventilation pattern analysis at xenon ventilation CT performed by using a dual-energy technique. Radiology 2010;256:985-997 https://doi.org/10.1148/radiol.10091502
  8. Kosuda S, Kadota Y, Kusano S, Sekine I. A combined study of Tc-99m Technegas and Xe-133 gas in suspected congenital bronchial atresia. Clin Nucl Med 2003;28:243-244
  9. Kamata S, Usui N, Kamiyama M, Nose K, Sawai T, Fukuzawa M. Long-term outcome in patients with prenatally diagnosed cystic lung disease: special reference to ventilation and perfusion scan in the affected lung. J Pediatr Surg 2006;41:2023-2027 https://doi.org/10.1016/j.jpedsurg.2006.08.020
  10. Suga K, Hara A, Matsumoto T, Matsunaga N. Intralobar bronchopulmonary sequestration: evidence of air trapping shown by dynamic xenon-133 SPECT. Br J Radiol 2001;74:657-661 https://doi.org/10.1259/bjr.74.883.740657
  11. Yang DH, Goo HW. Pediatric 16-slice CT protocols: radiation dose and image quality. J Korean Radiol Soc 2008;59:333-347 https://doi.org/10.3348/jkrs.2008.59.5.333
  12. Cetti EJ, Moore AJ, Geddes DM. Collateral ventilation. Thorax 2006;61:371-373 https://doi.org/10.1136/thx.2006.060509
  13. Kety SS. The theory and applications of the exchange of inert gas at the lungs and tissues. Pharmacol Rev 1951;3:1-41
  14. Chae EJ, Seo JB, Kim N, Song KS, Shin JH, Kim TH, et al. Collateral ventilation in a canine model with bronchial obstruction: assessment with xenon-enhanced dual-energy CT. Radiology 2010;255:790-798 https://doi.org/10.1148/radiol.10090947

Cited by

  1. Phenotyping airways disease: an A to E approach vol.42, pp.12, 2012, https://doi.org/10.1111/j.1365-2222.2012.04008.x
  2. Dual-Energy CT of the Lung vol.199, pp.5, 2011, https://doi.org/10.2214/ajr.12.9112
  3. CT Radiation Dose Optimization and Estimation: an Update for Radiologists vol.13, pp.1, 2011, https://doi.org/10.3348/kjr.2012.13.1.1
  4. Preliminary Application of High-Definition CT Gemstone Spectral Imaging in Hand and Foot Tendons vol.13, pp.6, 2011, https://doi.org/10.3348/kjr.2012.13.6.743
  5. An Engineering View on Megatrends in Radiology: Digitization to Quantitative Tools of Medicine vol.14, pp.2, 2011, https://doi.org/10.3348/kjr.2013.14.2.139
  6. Dual-energy lung perfusion and ventilation CT in children vol.43, pp.3, 2011, https://doi.org/10.1007/s00247-012-2465-4
  7. Advanced functional thoracic imaging in children: from basic concepts to clinical applications vol.43, pp.3, 2013, https://doi.org/10.1007/s00247-012-2466-3
  8. New insight into the assessment of asthma using xenon ventilation computed tomography vol.111, pp.2, 2011, https://doi.org/10.1016/j.anai.2013.04.019
  9. Xenon-Enhanced Dual-Energy CT Lung Ventilation Imaging: Techniques and Clinical Applications vol.202, pp.2, 2011, https://doi.org/10.2214/ajr.13.11191
  10. Computer-Aided Classification of Visual Ventilation Patterns in Patients with Chronic Obstructive Pulmonary Disease at Two-Phase Xenon-Enhanced CT vol.15, pp.3, 2011, https://doi.org/10.3348/kjr.2014.15.3.386
  11. Preliminary Application of High-Definition Computed Tomographic Gemstone Spectral Imaging in Lung Cancer vol.38, pp.1, 2014, https://doi.org/10.1097/rct.0b013e3182a21633
  12. A pilot study using low-dose Spectral CT and ASIR (Adaptive Statistical Iterative Reconstruction) algorithm to diagnose solitary pulmonary nodules vol.15, pp.None, 2011, https://doi.org/10.1186/s12880-015-0096-6
  13. Dual-Energy CT: New Horizon in Medical Imaging vol.18, pp.4, 2011, https://doi.org/10.3348/kjr.2017.18.4.555
  14. White Paper of the Society of Computed Body Tomography and Magnetic Resonance on Dual-Energy CT, Part 3: Vascular, Cardiac, Pulmonary, and Musculoskeletal Applications vol.41, pp.1, 2011, https://doi.org/10.1097/rct.0000000000000538
  15. Delayed ventilation assessment using fast dynamic hyperpolarised Xenon-129 magnetic resonance imaging vol.30, pp.2, 2011, https://doi.org/10.1007/s00330-019-06415-1