Late Breaking Abstract - MRI identifies functional and structural BPD characteristics in preterm infants at five years of age
Abstract
Background: Chronic lung disease, the most prevalent long-term complication after premature birth, lacks the routine characterization of structural changes. Objective: We compared changes to lung structure and perfusion using magnetic resonance imaging (MRI) in preterm infants born <32 weeks gestation near-term and preschool age. Methods: Near-term (n=88) and 4-8 years of age (n=26), preterms with/without Bronchopulmonary Dysplasia (BPD) underwent 3T MRI while spontaneously breathing (n=16 serial measurements; n=29 lung follow-up questionnaires). Standardized image assessment (5-point Likert scale) of coronal/axial/sagittal T2-weighted single-shot fast-spin-echo sequences included ‘emphysema’, ‘interstitial enhancement’, ‘airway accentuation’, and ‘ventilation inhomogeneity’. Pulmonary artery (PA) flow and area as well as cardiac function was quantified in flow sensitive gradient-echo sequences. Results: MRI-scoring revealed a persisting ‘emphysema’ phenotype in moderate/severe BPD children (term p=0.0017, preschool p=0.039; vs. noBPD). In contrast, changes in ‘interstitial enhancement’ only characterized BPD at term in the overall group (term p=0.0016, preschool p=0.69; vs. noBPD), while changes persisted when stratifying for clinical risk factors (postnatal infections, gender, and/or infections after discharge). ‘Airway accentuation’ was detected in mild BPD cases at preschool age. Abnormalities in PA flow, present in preterms with moderate/severe BPD at term, identified children with BPD at preschool age (AUC=0.85 [0.65-1.00]). Conclusions: The identification of persisting structural and functional changes in the BPD lung by MRI could inform treatment and monitoring strategies.
Authors 10
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Ludwig-Maximilians-Universität München
Affiliation as printed
Center for Comprehensive Developmental Care (CDeCLMU), social Pediatric Center (iSPZ), Dr. von Hauner Children's Hospital, Ludwig-Maximilians University, Munich, Germany, München, Germany
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LMU Klinikum · Ludwig-Maximilians-Universität München
Affiliation as printed
Center for Comprehensive Developmental Care (CDeCLMU), social Pediatric Center (iSPZ), Dr. von Hauner Children's Hospital, Ludwig-Maximilians University, Munich, Germany;Division of Neonatology, University Children's Hospital Dr. v. Hauner and Perinatal Center, LMU Hospital, Munich Germany, München, Germany
Center for Comprehensive Developmental Care (CDeCLMU), social Pediatric Center (iSPZ), Dr. von Hauner Children's Hospital, Ludwig-Maximilians University, Munich, Germany
Division of Neonatology, University Children's Hospital Dr. v. Hauner and Perinatal Center, LMU Hospital, Munich Germany, München, Germany
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Affiliation as printed
Metabolomics and Analytics Centre, Leiden Academic Centre for Drug Research (LACDR), Leiden University, Leiden, The Netherlands, Leiden, Netherlands
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Helmholtz Munich · German Center for Lung Research
Affiliation as printed
Institute for Lung Health and Immunity and Comprehensive Pneumology Center with the CPC-M bioArchive, Helmholtz Zentrum München, Member of the German Lung Research Center (DZL), Munich, Germany, München, Germany
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Helmholtz Munich · Institute of Computational Biology · Technical University of Munich
Affiliation as printed
Institute of Computational Biology, Helmholtz Zentrum München, Munich, Germany;Department of Mathematics, Technische Universität München, Garching, Germany, München, Germany
Department of Mathematics, Technische Universität München, Garching, Germany, München, Germany
Institute of Computational Biology, Helmholtz Zentrum München, Munich, Germany
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Ludwig-Maximilians-Universität München
Affiliation as printed
Center for Comprehensive Developmental Care (CDeCLMU), social Pediatric Center (iSPZ), Dr. von Hauner Children's Hospital, Ludwig-Maximilians University, Munich, Germany;Department of Pediatric Neurology, Dr. von Hauner Children's Hospital, Ludwig-Maximilians University, Munich, Germany, München, Germany
Center for Comprehensive Developmental Care (CDeCLMU), social Pediatric Center (iSPZ), Dr. von Hauner Children's Hospital, Ludwig-Maximilians University, Munich, Germany
Department of Pediatric Neurology, Dr. von Hauner Children's Hospital, Ludwig-Maximilians University, Munich, Germany, München, Germany
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LMU Klinikum · Ludwig-Maximilians-Universität München
Affiliation as printed
Division of Neonatology, University Children's Hospital Dr. v. Hauner and Perinatal Center, LMU Hospital, Munich Germany, München, Germany
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LMU Klinikum · German Center for Lung Research · Ludwig-Maximilians-Universität München
Affiliation as printed
Department of Radiology, University Hospital, Ludwig-Maximilians University Munich, Germany, Member of the German Center for Lung Research (DZL), München, Germany
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LMU Klinikum · German Center for Lung Research · Ludwig-Maximilians-Universität München
Affiliation as printed
Department of Radiology, University Hospital, Ludwig-Maximilians University Munich, Germany, Member of the German Center for Lung Research (DZL), München, Germany
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Helmholtz Munich · Ludwig-Maximilians-Universität München
Affiliation as printed
Center for Comprehensive Developmental Care (CDeCLMU), social Pediatric Center (iSPZ), Dr. von Hauner Children's Hospital, Ludwig-Maximilians University, Munich, Germany;Institute for Lung Health and Immunity and Comprehensive Pneumology Center with the CPC-M bioArchive, Helmholtz Zentrum München, Member of the German Lung, München, Germany
Center for Comprehensive Developmental Care (CDeCLMU), social Pediatric Center (iSPZ), Dr. von Hauner Children's Hospital, Ludwig-Maximilians University, Munich, Germany
Institute for Lung Health and Immunity and Comprehensive Pneumology Center with the CPC-M bioArchive, Helmholtz Zentrum München, Member of the German Lung, München, Germany
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