Prematurely born infants often develop a chronic lung disease known as Bronchopulmonary Dysplasia (BPD). To date, it has only been possible to diagnose the condition based on clinical symptoms and with little differentiation.
DZL researchers at the Helmholtz Center in Munich and the Medical Center of the University of Munich have therefore developed a new protocol, allowing them to identify premature infants suffering from the disease by magnetic resonance imaging (MRI). Their findings have been published in Thorax.
Around 15 to 30 percent of all premature infants with a birth weight of less than 1,000 g or born before week 32 of pregnancy develop BPD1. Depending on the severity of the disease, BPD causes lung dysfunction, which may be present through to adulthood and, in some cases, result in death. “So far, we have only been able to diagnose at a late stage and with little differentiation if the baby will develop the condition or not,” says PD Dr. Anne Hilgendorff. She leads the work group “Mechanisms of Chronic Lung Disease in Newborns” at the Institute of Lung Biology and Disease (ILBD) and the Comprehensive Pneumology Center (CPC) of the Helmholtz Center in Munich. She is also the director of the Center for Comprehensive Developmental Care at the Medical Center of the University of Munich. Dr. Hilgendorff says: “Specific options to evaluate structural lung changes while avoiding harmful radiation have not been available in the past, which has made personalized treatment and follow-up difficult.” A new MRI protocol may now be able close this gap.
“With our research team², in close cooperation with our colleagues of the Perinatal Center at the Medical Center of the University of Munich as well as the Department of Radiology, we have evaluated the examination of 61 premature infants,” says Dr. Kai Förster, a member of Hilgendorff’s work group. All babies participating in the study were born before week 32 of pregnancy. They were already breathing on their own during the examination, which was carried out shortly after the date of birth, so the MRI could be performed during spontaneous sleep. During the statistical analysis of the imaging data in cooperation with the Institute of Computational Biology (ICB) at the Helmholtz Center in Munich, increased T2 and decreased T1 relaxation time³ in the MRI indicated the presence of BPD. “Our findings are an important step toward improved, imaging-based phenotyping of infants at risk of developing the disease,” says Dr. Hilgendorff. “This will enable individual treatment and monitoring approaches in the future.” According to Dr. Hilgendorff, it is now important that large perinatal centers make use of this method and analyze it together in order to identify any potential subtypes of Bronchopulmonary Dysplasia.
PD Dr. Anne Hilgendorff
Helmholtz Center in Munich
Institute of Lung Biology and Disease & Comprehensive Pneumology Center
Email: a.Hilgendorff@med.uni-muenchen.de
Go to the idw press release of the Helmholtz Center in Munich (in German)
1BPD probably results from various risk factors, such as inflammatory processes, microtrauma caused by ventilation therapy, and the toxicity of oxygen radicals affecting immature lung tissue. In the long term, tissue that is important for gas exchange is damaged and becomes scarred.
²Researchers including those of the Institute of Computational Biology (Helmholtz Center in Munich), the Department of Radiology (Medical Center of the University of Munich), and the Department of Pediatrics/Neonatology (Medical Center of the University of Munich) have contributed significantly to this ³MRI systems are based on the following principle: Hydrogen nuclei can be compared with small magnets. In a strong external magnetic field, they align in parallel to or opposing this field. When energy is applied as radio frequency pulses, nearly all hydrogen atoms temporarily align in the same direction. After that, they release the energy again and lose their orientation. Two separate processes, T1 and T2 relaxation, describe this process. MRI systems do not use X-rays.
For a detailed multimedia reportage on the project of Anne Hilgendorff and Kai Förster, please refer to: https://www.cpc-munich.de/en/lung-research-360/ventilation-of-premature-babies-curse-and-blessing-at-the-same-time/index.html
