The results show that MRI may offer clinicians a useful alternative to CT to evaluate patients with COVID-19 in the future, especially since these long-term symptoms may be subtle, writes a team led by Alexander Mathison, a PhD student at Western University in London. , Canada.
“Because MRI directly examines the function of the alveolar-capillary border, it may be more sensitive or more targeted than CT to microvascular abnormalities,” the group said.
Previous studies have shown that the incidence of symptoms after COVID-19 in people who are at least 12 weeks after the initial infection – such as difficulty breathing both at rest and with exertion, fatigue, exercise restriction, muscle weakness and cognitive deficits (t .f. “brain fog”) – varies from 20% to 81%, the researchers explained.
These symptoms can be difficult to identify and treat, as they often cannot be permanently confirmed by instruments such as spirometry, lung tests, or even CT scans. Also, previous studies have looked at the long-term effects of COVID-19 in patients who have been hospitalized for it, not in those who have never been hospitalized.
Xe-129 MRI offers the ability to identify “capillary-level abnormalities by detecting inhaled Xe-129 dissolved in the alveolar membrane,” the group wrote. Matheson and colleagues studied all the links between persistent COVID-19 symptoms and exercise limitations in 34 patients who became infected with COVID-19 but were never hospitalized using Xe-129 MRI and CT pulmonary vascular measurements. Their study also included six healthy controls.
Patients with post-acute COVID-19 syndrome underwent spirometry, a lung test called lung oxide diffusion capacity (DLCO), Xe-129 MRI, and chest CT, while healthy controls had each of these tests. except for chest CT.
The team monitored the ratios of red blood cells to the alveolar barrier signal and the areas of red blood cells below the curve (AUC) examined by Xe-129 MRI. Survey participants also completed various questionnaires to assess their quality of life, exercise limitations, and difficulty breathing.
Magnetic resonance imaging of Xe-129 showed worse values in lung health measures, such as lung diffusion capacity for carbon monoxide, exercise capacity and ease of breathing (conditions that were associated with the findings of Xe-129 MRI for what the team referred to as the “red” area of blood cells below the spectroscopy curve, calling it “AUC”). MRI results also correlated with poor CT results of pulmonary vascular density.
“In our study, [Xe-129 MRI suggests] temporary persistent pulmonary vascular density and gas transfer abnormalities associated with exercise limitation and dyspnea on exertion, the researchers wrote. -129 MRI measurements are worse in patients never hospitalized than in controls. “
The findings are promising, but the study has several limitations: namely, the method by which Xe-129 MRI studies were conducted and what they show about gas transport and age differences between healthy and patients, writes Dr. Jim Wilde, and Guilhem Collier. PhD, both from the University of Sheffield in the United Kingdom, in an accompanying editorial.
“We are really pleased to see that this work adds to the MRI literature of dissolved xenon in lung disease after COVID, and we share the urgency to understand the symptoms of lung disease after COVID,” they wrote. “However, we need to make sure that the findings are reasonably recorded with age-appropriate normative data before clinically relevant conclusions can be drawn.”
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