Asthma diagnosis and treatmentThe variability of regional airflow obstruction within the lungs of patients with asthma: Assessment with hyperpolarized helium-3 magnetic resonance imaging
Section snippets
Methods
Our study involving patients with asthma was designed to enroll only young subjects between 18 and 35 years of age to maximize confidence in the diagnosis of the asthma because older adults may have chronic obstructive pulmonary disease, a condition that can mimic asthma. Patients had to carry the diagnosis of asthma as determined by their primary physician, and they had to have no history of other lung disease or smoking and no contraindications for MRI. Each subject was asked to complete a
Results
The study group consisted of 10 patients, all female, with a mean age of 20.9 years (Table I). That all patients were female was determined by chance because no selection bias occurred in the design of the study with respect to gender. Based on the answers from the NAEPP symptom questionnaire and the spirometry obtained on each study day, 1 subject had mild intermittent, 6 had mild persistent, and 3 had moderate persistent asthma on study day 1, and 3 had mild intermittent, 3 had mild
Discussion
Several important observations were made in this study. First, as would be expected when stimulating bronchoconstriction, most ventilation defects on the postmethacholine images were new as compared with the baseline (premethacholine) images. Most likely, these defects were the result of decreased filling of the airways with the H3He gas from the increased bronchoconstriction induced by the methacholine. What is most interesting, however, is that most defects that were present on the first
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Supported by the National Heart, Lung, and Blood Institute of the National Institutes of Health (grant RO1 HL 66479), the Commonwealth of Virginia Technology Research Fund (grant IN2002-01), and Siemens Medical Solutions.
Disclosure of potential conflict of interest: J. R. Brookeman and J. P Mugler have received grant support from Siemens Medical Solutions. The rest of the authors have declared that they have no conflict of interest.
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Dr Altes is currently affiliated with the Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, Pa.