Journal of magnetic resonance imaging : JMRI · 2026
Exercise-Induced Alterations in Lung Water Density in Heart Failure Using Single-Breath-Hold 3D Ultrashort Echo Time MRI.
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Chen Hang, Morales Manuel A, Schulz Alexander, Rodriguez Jennifer, Ghanbari Fahime, Benkert Thomas, Manning Warren J, Thompson Richard B, Nezafat Reza
Аннотация
BACKGROUND: Evaluating pulmonary congestion after exercise in heart failure (HF) may reveal perturbations not apparent at rest and provide insight into dyspnea and exercise intolerance.
PURPOSE: To investigate the reproducibility and exercise-induced alterations in lung water density (LWD) using 3D ultrashort echo time (UTE) MRI.
STUDY TYPE: Prospective.
FIELD STRENGTH/SEQUENCE: 3-T MRI with a prototype 3D stack-of-spirals UTE Volumetric Interpolated Breath-hold Examination (VIBE) sequence.
POPULATION: Sixty-nine HF patients (59 ± 12 years; 39 males) across a range of left ventricular ejection fraction (23 HFpEF, 16 HFmrEF, 18 HFimpEF, and 12 HFrEF); 34 healthy subjects.
ASSESSMENT: UTE MRI was performed at rest and after exercise. Images were normalized to yield relative LWD (%). LWD was quantified as the mean normalized pixel intensity within the segmented parenchyma, and lung volume was also measured. Reproducibility was evaluated in a separate scan/rescan study.
STATISTICAL TESTS: Shapiro-Wilk test; one-way ANOVA or Kruskal-Wallis test with FDR correction; Student's t-test or Wilcoxon signed-rank test; χ 2 test or Fisher's exact test; Bland-Altman analysis. p < 0.05 was considered significant.
RESULTS: In healthy controls, LWD decreased significantly after exercise with an absolute change of -1.25% (interquartile range [IQR]: -2.92% to 0.38%) and relative change of -4.35% (IQR: -9.55% to 1.30%). Compared with controls, HFpEF showed a significantly greater absolute change (0.47%, IQR: -0.91% to 2.10%) and relative change in LWD (1.46%, IQR: -2.65% to 6.45%), not apparent in other HF subgroups (p = 0.053-0.821). Changes in lung volume did not differ between each HF subgroup and healthy controls (p = 0.056-0.498). Bland-Altman analysis demonstrated good agreement for LWD and lung volume.
DATA CONCLUSION: Single-breath-hold 3D UTE MRI provides reproducible LWD measurements at rest and enables detection of exercise-induced LWD alterations. This approach captures pulmonary fluid changes following exercise and identifies greater LWD response in HFpEF.
TECHNICAL EFFICACY: Stage 1.
PURPOSE: To investigate the reproducibility and exercise-induced alterations in lung water density (LWD) using 3D ultrashort echo time (UTE) MRI.
STUDY TYPE: Prospective.
FIELD STRENGTH/SEQUENCE: 3-T MRI with a prototype 3D stack-of-spirals UTE Volumetric Interpolated Breath-hold Examination (VIBE) sequence.
POPULATION: Sixty-nine HF patients (59 ± 12 years; 39 males) across a range of left ventricular ejection fraction (23 HFpEF, 16 HFmrEF, 18 HFimpEF, and 12 HFrEF); 34 healthy subjects.
ASSESSMENT: UTE MRI was performed at rest and after exercise. Images were normalized to yield relative LWD (%). LWD was quantified as the mean normalized pixel intensity within the segmented parenchyma, and lung volume was also measured. Reproducibility was evaluated in a separate scan/rescan study.
STATISTICAL TESTS: Shapiro-Wilk test; one-way ANOVA or Kruskal-Wallis test with FDR correction; Student's t-test or Wilcoxon signed-rank test; χ 2 test or Fisher's exact test; Bland-Altman analysis. p < 0.05 was considered significant.
RESULTS: In healthy controls, LWD decreased significantly after exercise with an absolute change of -1.25% (interquartile range [IQR]: -2.92% to 0.38%) and relative change of -4.35% (IQR: -9.55% to 1.30%). Compared with controls, HFpEF showed a significantly greater absolute change (0.47%, IQR: -0.91% to 2.10%) and relative change in LWD (1.46%, IQR: -2.65% to 6.45%), not apparent in other HF subgroups (p = 0.053-0.821). Changes in lung volume did not differ between each HF subgroup and healthy controls (p = 0.056-0.498). Bland-Altman analysis demonstrated good agreement for LWD and lung volume.
DATA CONCLUSION: Single-breath-hold 3D UTE MRI provides reproducible LWD measurements at rest and enables detection of exercise-induced LWD alterations. This approach captures pulmonary fluid changes following exercise and identifies greater LWD response in HFpEF.
TECHNICAL EFFICACY: Stage 1.