Imaging functional and microstructural changes in the lungs of children born prematurely

Introduction: Preterm-births account for 10% of worldwide births, and those born at 32 weeks gestation or less have deterioration in their lung function in childhood and beyond. A combination of birth at an early stage of lung development and postnatal interventions such as mechanical ventilation and supplemental oxygen therapy can lead to the development of bronchopulmonary dysplasia, BPD, for example. Aims: Here we assessed pulmonary micro-structural and functional changes in the lungs using hyperpolarized 129Xe gas ventilation and diffusion-weighted MRI in three groups of children (mean age 10 y): (1) those born preterm with FEV1 Results: 129Xe ventilation defect percentage was significantly higher in children born preterm than in term born children, (groups 1-3 p=0.0184, and for groups 2-3 p=0.0262). Children born preterm ventilation heterogeneity measured by CV% was significantly higher in those with FEV1 The kurtosis of the distribution of mean alveolar dimension (LmD) was significantly lower in children born preterm when compared to those born at term (subjects (group 1-3 (p=0.02) and group 2-3 (p=0.05)) suggesting an increased heterogeneity of alveolar microstructural dimensions measured by diffusion-weighted MRI. Conclusion: 129Xe ventilation and diffusion imaging detected functional and microstructural changes in the lungs of children born prematurely, neither of which were detected by FEV1 or multiple-breath washout.