MRI Improves Analysis of Bronchopulmonary Dysplasia

Published November 15, 2015
American Journal of Respiratory and Critical Care Medicine

Physicians have long faced challenges in detecting subtle differences in bronchopulmonary dysplasia (BPD), a serious but poorly characterized complication in premature infants.

Most infants with BPD are born more than 10 weeks early, at less than two pounds. However, two leading diagnostic options come with limitations.

Radiation from CT scans can pose a risk to these especially fragile infants. Meanwhile, tracking oxygen dependence at 36 weeks gestational age does not provide objective measures of structural abnormalities across disease severity.

Now a third option — magnetic resonance imaging (MRI) — is emerging, according to research published Nov. 15, 2015, in the American Journal of Respiratory and Critical Care Medicine.

“We demonstrated that we can differentiate subtle differences in mild and more severe disease,” says Jason Woods, PhD, director, Center for Pulmonary Imaging Research. “We also can perform the scans in the NICU itself.

The research team included center colleague and first author Laura Walkup, PhD, and Raouf Amin, MD, director, Pulmonary Medicine.

The team used a unique, small-footprint MRI scanner — developed at Cincinnati Children’s — that is located in the NICU. The team scanned six premature infants with BPD, six premature patients without BPD, and six full-term NICU patients.

A radiologist graded the images using a modified Ochiai score. The team also used segmentation and threshold analysis to quantify volumes of high- and low-signal intensity lung parenchyma.

The MRI detected quantifiable, significant differences in lung tissue between the three groups. “These methods,” the authors wrote, “could be implemented to individually phenotype disease, which may impact clinical care and predict future outcomes.”

Fig A:  Researchers used MRI to compare the axial fast gradiant echo slice of four premature babies, three with bronchopulmonary dysplasia (BPD) and one without. The MRIs more clearly indicate that Patient BPD5 shows signs of fibrotic opacities. In Patients BPD2 and BPD3, these features and multiple regions of emphysema and hyperexpansion are described in the X-rays.
Click image to view caption.


Walkup LL, Tkach JA, Higano NS, Thomen RP, Fain SB, Merhar SL, Fleck RJ, Amin RS, Woods JC. Quantitative Magnetic Resonance Imaging of Bronchopulmonary Dysplasia in the Neonatal Intensive Care Unit Environment. Am J Respir Crit Care Med. 2015 Nov 15;192(10):1215-22.

A photo of Jason Woods.

Jason Woods, PhD

A photo of Laura Walkup, PhD. 

Laura Walkup, PhD