Volume 20 No 22 (2022)
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PATIENTS WITH PAEDIATRIC STEM CELL TRANSPLANTS WHO CANNOT PERFORM SPIROMETRY ARE DETECTED BY XENON-129 MRI
J. Sanmathi Anbu and J. Jai Kishor
Abstract
Because spirometry is insensitive to early changes following haematopoietic stem cell transplantation (HSCT), The detection of pulmonary morbidity remains a major challenge for intervention, and patient compliance presents additional challenges in paediatrics. The An investigation of regional lung ventilation abnormalities is being carried out in children undergoing HSCT by 129Xe hyperpolarized MRI and spirometry. An MRI was performed on 20 paediatric allogeneic HSCT patients (aged 5–15 years) after breath-holding hyperpolarized 129Xe gas. In lungs with poor ventilation, a ventilation defect percentage (VDP) was used to quantify ventilation deficits caused by obstruction. A forced expiratory volume in one second (FEV1), a force expiratory volume to forced vital capacity ratio (FVC), as well as forced expiratory flow measured by spirometry (FEF25– 75%) were also used.According to the results of 129Xe, VDP had a median and standard deviation of 10.4±9.4% (range 2.6–41.4%). According to 129Xe VDP, there is an inverse correlation between FEV1, FEV1/FVC ratio, and FEF25-75%. It has been reported that 129Xe MRI can detect early obstruction in patients with normal spirometry (FEV1 >80%). Two patients will have ventilation deficits, so abnormal conditions that would otherwise have gone undetected and untreated cannot be detected and treated. Five patients will be unable to perform spirometry, but five others will have ventilation deficits.Patients with asymptomatic paediatric HSCT and those who could not perform reliable spirometry were found to have lung ventilation deficits using hyperpolarised 129Xe gas MRI. A reliable method of assessing the involvement of the lungs in children is the 129Xe MRI.
Keywords
MRI, Xenon-129, haematopoietic stem cell transplantation. forced vital capacity ratio
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