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Hellbach, K.* ; Yaroshenko, A.* ; Willer, K.* ; Pritzke, T. ; Baumann, A.* ; Hesse, N.* ; Auweter, S.* ; Reiser, M.F.* ; Eickelberg, O. ; Pfeiffer, F.* ; Hilgendorff, A.* ; Meinel, F.G.*

Facilitated diagnosis of pneumothoraces in newborn mice using x-ray dark-field radiography.

Invest. Radiol. 51, 597-601 (2016)
Verlagsversion DOI
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OBJECTIVE: The aim of this study was to evaluate the diagnostic value of x-ray dark-field imaging in projection radiography-based depiction of pneumothoraces in the neonatal murine lung, a potentially life-threatening medical condition that requires a timely and correct diagnosis. MATERIALS AND METHODS: By the use of a unique preclinical model, 7-day-old C57Bl/6N mice received mechanical ventilation for 2 or 8 hours with oxygen-rich gas (FIO2 = 0.4; n = 24). Unventilated mice either spontaneously breathed oxygen-rich gas (FIO2 = 0.4) for 2 or 8 hours or room air (n = 22). At the end of the experiment, lungs were inflated with a standardized volume of air after a lethal dose of pentobarbital was administered to the pups. All lungs were imaged with a prototype grating-based small-animal scanner to acquire x-ray transmission and dark-field radiographs. Image contrast between the air-filled pleural space and lung tissue was quantified for both transmission and dark-field radiograms. After the independent expert's assessment, 2 blinded readers evaluated all dark-field and transmission images for the presence or absence of pneumothoraces. Contrast ratios, diagnostic accuracy, as well as reader's confidence and interreader agreement were recorded for both imaging modalities. RESULTS: Evaluation of both x-ray transmission and dark-field radiographs by independent experts revealed the development of a total of 10 pneumothoraces in 8 mice. Here, the contrast ratio between the air-filled pleural space of the pneumothoraces and the lung tissue was significantly higher in the dark field (8.4 ± 3.5) when compared with the transmission images (5.1 ± 2.8; P < 0.05). Accordingly, the readers' diagnostic confidence for the diagnosis of pneumothoraces was significantly higher for dark-field compared with transmission images (P = 0.001). Interreader agreement improved from moderate for the analysis of transmission images alone (κ = 0.41) to very good when analyzing dark-field images alone (κ = 0.90) or in combination with transmission images (κ = 0.88). Diagnostic accuracy significantly improved for the analysis of dark-field images alone (P = 0.04) or in combination with transmission images (P = 0.02), compared with the analysis of transmission radiographs only. CONCLUSIONS: The significant improvement in contrast ratios between lung parenchyma and free air in the dark-field images allows the facilitated detection of pneumothoraces in the newborn mouse. These preclinical experiments indicate the potential of the technique for future clinical applications.
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Publikationstyp Artikel: Journalartikel
Dokumenttyp Wissenschaftlicher Artikel
Schlagwörter Neonatal Lung Injury ; Mechanical Ventilation ; Pneumothorax ; Disease Diagnosis ; X-ray Dark-field Imaging ; Grating-based X-ray Imaging ; X-ray Phase-contrast Imaging; Occult Pneumothoraces; Computed-tomography; Pulmonary-emphysema; Trauma Patients; Image Quality; Lung Growth; Interferometer; Management; System
ISSN (print) / ISBN 0020-9996
e-ISSN 1536-0210
Quellenangaben Band: 51, Heft: 10, Seiten: 597-601 Artikelnummer: , Supplement: ,
Verlag Lippincott Williams & Wilkins
Verlagsort Hagerstown, Md.
Begutachtungsstatus Peer reviewed