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X-ray Phase-contrast imaging

Martin Bech

Universitetslektor

X-ray Phase-contrast imaging

Distinct types of plexiform lesions identified by synchrotron-based phase-contrast micro-CT

Författare

  • Christian Westoo
  • Christian Norvik
  • Niccolo Peruzzi
  • Oscar van der Have
  • Goran Lovric
  • Ida Jeremiasen
  • Phan Kiet Tran
  • Rajmund Mokso
  • Vinicio de Jesus Perez
  • Hans Brunnstrom
  • Martin Bech
  • Csaba Galambos
  • Karin Tran-Lundmark
Visa allt

Summary, in English

In pulmonary arterial hypertension, plexiform lesions are associated with severe arterial obstruction and right ventricular failure. Exploring their structure and position is crucial for understanding the interplay between hemodynamics and vascular remodeling. The aim of this research was to use synchrotron-based phase-contrast micro-CT to study the three-dimensional structure of plexiform lesions. Archived paraffin-embedded tissue samples from 14 patients with pulmonary arterial hypertension (13 idiopathic, 1 with known BMPR2-mutation) were imaged. Clinical data showed high-median PVR (12.5 WU) and mPAP (68 mmHg). Vascular lesions with more than 1 lumen were defined as plexiform. Prior radiopaque dye injection in some samples facilitated 3-D rendering. Four distinct types of plexiform lesions were identified: 1) localized within or derived from monopodial branches (supernumerary arteries), often with a connection to the vasa vasorum; 2) localized between pulmonary arteries and larger airways as a tortuous transformation of intrapulmonary bronchopulmonary anastomoses; 3) as spherical structures at unexpected abrupt ends of distal pulmonary arteries; and 4) as occluded pulmonary arteries with recanalization. By appearance and localization, types 1–2 potentially relieve pressure via the bronchial circulation, as pulmonary arteries in these patients were almost invariably occluded distally. In addition, types 1–3 were often surrounded by dilated thin-walled vessels, often connected to pulmonary veins, peribronchial vessels, or the vasa vasorum. Collaterals, bypassing completely occluded pulmonary arteries, were also observed to originate within plexiform lesions. In conclusion, synchrotron-based imaging revealed significant plexiform lesion heterogeneity, resulting in a novel classification. The four types likely have different effects on hemodynamics and disease progression.

Avdelning/ar

  • Kärlväggsbiologi
  • Medicinsk strålningsfysik, Lund
  • MAX IV-laboratoriet
  • Förbättrad diagnostik och prognostik vid lungcancer och metastaser till lunga
  • Institutionen för laboratoriemedicin
  • X-ray Phase Contrast
  • WCMM- Wallenberg center för molekylär medicinsk forskning

Publiceringsår

2021-07-01

Språk

Engelska

Sidor

17-28

Publikation/Tidskrift/Serie

American Journal of Physiology - Lung Cellular and Molecular Physiology

Volym

321

Issue

1

Dokumenttyp

Artikel i tidskrift

Förlag

American Physiological Society

Ämne

  • Physiology
  • Medical Image Processing
  • Other Physics Topics

Nyckelord

  • Imaging
  • Lung
  • Plexiform lesion
  • Pulmonary arterial hypertension
  • Synchrotron

Status

Published

Forskningsgrupp

  • Vessel Wall Biology
  • Improved diagnostics and prognostics of lung cancer and metastases to the lungs
  • X-ray Phase Contrast

ISBN/ISSN/Övrigt

  • ISSN: 1040-0605