Abstract
BackgroundDiffusion tensor imaging (DTI) is a non-invasive MR modality that provides an evaluation of brain tissue microstructure and architecture in vivo. We aimed to assess the diagnostic value of DTI parameters in evaluating cerebral white matter integrity in patients of severe chronic obstructive pulmonary disease (COPD) and correlate these parameters with smoking index (SI) and the number of exacerbations in the last year.This prospective study included 30 COPD male past smoker patients and 15 age- and sex-matched nonsmoker controls. Staging of COPD, SI and number of exacerbations in the last year were obtained. Routine brain MRI and DTI were done in all subjects. The selected white matter tracts’ fractional anisotropy (FA), and mean diffusivity (MD) were calculated in the region of interest in axial slices.ResultsThe mean FA and MD values of all selected white matter tracts showed a high significant difference (p < 0.001) between patients and control group. The correlation between FA, SI and exacerbation frequency was not significant in the majority of white matter tracts (p > 0.05). The correlation between MD, SI and exacerbation frequency was significant for the majority of tracts (p < 0.05).ConclusionDTI metrics are valuable non-invasive tools in evaluating the white matter abnormalities in COPD patients. Smoking index and frequency of exacerbations have possible relation to extra-pulmonary cerebral manifestations of COPD.
Highlights
Diffusion tensor imaging (DTI) is a non-invasive MR modality that provides an evaluation of brain tissue microstructure and architecture in vivo
It has been found that Chronic obstructive pulmonary disease (COPD) is linked to cerebral small vessel disease through increased prevalence of white matter lesions, and cerebral microbleeds
This work aims to assess the diagnostic value of DTI parameters in evaluating the changes and microstructural abnormalities of white matter tracts in patients of severe chronic obstructive pulmonary disease and correlate these parameters with smoking index and the number of exacerbations in the last year. This is a prospective case-control study that was performed after the approval from our institutional review board and informed consents were obtained from all patients before scanning
Summary
Diffusion tensor imaging (DTI) is a non-invasive MR modality that provides an evaluation of brain tissue microstructure and architecture in vivo. We aimed to assess the diagnostic value of DTI parameters in evaluating cerebral white matter integrity in patients of severe chronic obstructive pulmonary disease (COPD) and correlate these parameters with smoking index (SI) and the number of exacerbations in the last year. This prospective study included 30 COPD male past smoker patients and 15 age- and sex-matched nonsmoker controls. Conventional magnetic resonance imaging (MRI) has been used for detection of structural brain changes seen in cerebral small vessel disease which is common in elderly and in those with impaired pulmonary function. Cerebral microstructural changes at the cellular level still are not within the scope of the conventional MRI spatial resolution [5, 6]
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