Graham Norquay1, Guilhem J. Collier1, Rolf F. Schulte2, and Jim M. Wild1
1Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom, 2GE Healthcare, Munich, Germany
Synopsis
3D
density-weighted MRSI was used to regionally measure the 129Xe chemical
shift from xenon in the lung airspaces (G), lung tissue/plasma (TP) and pulmonary
red blood cells (RBC) at three lung inflation states. The 129Xe-RBC
and 129Xe-G chemical shifts were both found to increase with
increasing lung inflation (increase in alveolar pO2) while the 129Xe-TP
shift was observed to be lung-inflation independent. The RBC chemical shift
maps presented here may be used in patient populations to detect areas of low
blood oxygenation in diseases presenting regional hypoxia in the lungs and
other well-perfused organs such as the brain and kidneys.
Introduction
MR
imaging and spectroscopy of hyperpolarised 129Xe dissolved in
pulmonary red blood cells (RBCs) and parenchymal tissue/plasma (TP) is of
interest for investigating a range of cardiopulmonary diseases.1 It has been shown previously that the
129Xe-RBC resonance is sensitive to oxygenation, exhibiting a
non-linear increase in chemical shift with increasing blood oxygenation.2,3 The relationship between the 129Xe-RBC
chemical shift and RBC oxygenation has been used previously to detect changes in lung
blood oxygenation by acquiring MR spectra of hyperpolarised 129Xe
during breath-hold apnoea.3 While offering a promising method to
non-invasively measure blood/tissue oxygenation, spectra in those experiments were acquired
globally and therefore did not provide regional measurements of lung blood
oxygenation. The goal of this work was to implement and validate 3D
density-weighted MRSI for 129Xe-RBC chemical
shift/oxygenation mappings of the lungs and to determine the effect of lung
inflation on the 129Xe chemical shift by performing the measurements
at three lung inflation levels.Methods
A spectrally-tailored RF pulse4 with a duration of 1.2ms and partial
self-refocusing was designed for scanning at 1.5T to excite the dissolved and
gas phase with flip angles of 10° and 0.1°, respectively. A 3D density-weighted
MRSI trajectory was designed with an isotropic voxel size of (2.9 cm)3,
matrix size of 14×14×7 and a FOV=40×40×20cm3, requiring a total
of 1799 RF excitations. In the spectral dimension, 88 sample points were acquired
with BW=20kHz. An optimised crusher gradient and RF spoiling scheme with TR=8ms
(TE=0.9ms) resulted in a total acquisition time of 14.4s, suitable for a single
breath-hold.
Spectra were zero-filled to 256 samples and reconstructed for frequency-domain
processing. After masking, data were fit to a three-peak Lorentzian to
determine the RBC, TP and G peak positions.
The sequence was acquired during breath-hold on a healthy male
volunteer at three different lung inflation states: residual volume (RV)+1L,
functional residual capacity (FRC)+1L and total lung capacity (TLC). Each
breath-hold consisted of inhaling 1L of enriched xenon gas (86% 129Xe)
polarised to ~30%5 on a 1.5T HDx GE scanner equipped with a 129Xe transmit-receive
vest coil (CMRS).
Histogram analysis was performed to determine parameters describing the
chemical shift distribution corresponding to RBC, TP and G resonances for each
lung inflation state.Results and Discussion
129Xe chemical shift maps for RBC, TP and G resonances are
shown in Fig. 1. The RBC chemical shift exhibits higher values towards the
lateral edges of the lungs, with the biggest variation observed in the middle
slices at TLC. This suggests blood in the alveolar capillaries towards the
outer edges of the lungs may be more oxygenated when compared to blood within
alveolar capillaries more proximal to the heart. There is no clear trend in the
TP chemical shift over the lungs at any of the lung inflation states. The G chemical shift is lower by ~1.5 ppm in the
apices and bases when compared to the mid-section of the lungs at TLC. This is consistent with
previous observations where it was reported that spherical microscopic magnetic
susceptibility effects cause portions of the lungs with larger alveolar-space/conducting-airway
ratios (apices and bases) to have ~2ppm lower G chemical shift values.6 However, larger length scale bulk magnetic susceptibility effects may also play a role, with significant susceptibility gradients present at the bases and apices of the lungs as observed previously with SPGR signal dephasing and SSFP banding in hyperpolarised gas ventilation MRI.7-9
All 129Xe chemical shift distributions followed an
approximate normal distribution (skew <0.5) with the exception of the G
resonance at TLC which exhibited a negative skew of ~-0.69 (Fig. 2, Fig. 4).
This may be attributed to the opening up of conducting airways, where a
reduction in spherical microscopic magnetic susceptibility effects should shift the G
resonance downfield (positive ppm shift). Additionally, expansion of the alveoli at TLC causes a smaller fraction of 129Xe nuclei to be in contact with heterogeneous diamagnetic tissue interfaces, potentially adding to the skewed G chemical shift distribution at TLC.
The mean RBC and G chemical shifts were found to increase with
increased lung inflation level while the TP chemical shift remained approximately constant at
all three lung inflation states (Fig. 3, Fig. 4), suggesting an increase in pO2
at elevated lung inflation is predominantly responsible for the observed increases in the RBC
and G chemical shift values. This is consistent with previous observations of RBC
shift increases with blood oxygen saturation3 and an expected downfield shift of the G peak from reports of gaseous xenon interactions
with molecular oxygen (0.939 ppm/amagat as reported in ref.10).Conclusions
Density-weighted MRSI was used to regionally quantify the 129Xe
chemical shifts from RBCs, TP and G resonances in the lungs. The RBC and G shifts were found to
increase with increasing lung inflation/pO2 elevation while the TP shift exhibited lung-inflation independence, suggesting the TP resonance is a potentially a more
reliable reference peak against which to quantify RBC shifts for experiments
performed at variable lung inflations. More generally, the RBC chemical shift
mapping approach described here may be of use in measuring low
blood oxygenation in lung diseases that cause focal hypoxia in the lungs and in other well-perfused organs such as the brain and kidneys.Acknowledgements
This work was funded by
the University of Sheffield, Medical Research Council (MR/M022552/1) and the National
Institute for Health Research (NIHR-RP-R3-12-027). References
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