Free-breathing low-field MRI of the lung exhibits functional damages associated with persistent symptoms in Covid-19 patients
Simon Lévy1, Rafael Heiss1, Robert Grimm2, David Grodzki2, Andreas Voskrebenzev3,4, Jens Vogel-Claussen3,4, Florian Fuchs5, Richard Strauss5, Susanne Achenbach6, Daniel Klett5, Jonas Schmid5, Andreas E. Kremer5,7, Michael Uder1, Armin M. Nagel1, and Sebastian Bickelhaupt1
1Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany, 2MR Application Predevelopment, Siemens Healthcare, Erlangen, Germany, 3Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany, 4Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany, 5Department of Medicine 1, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany, 6Department of Transfusion Medicine and Haemostaseology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany, 7Department of Gastroenterology and Hepatology, University Hospital Zürich, Zürich, Switzerland
Free-breathing lung images were acquired at 0.55T in 73 Covid-19 patients, on average 5.4 months after the symptoms onset. Perfusion, fractional ventilation and Flow-Volume Loop correlation (FVLc) maps were extracted with the Phase-Resolved Functional Lung analysis technique, and percentages of defect areas were calculated. The most relevant predictors of the presence of persistent symptoms were the areas with concurrent perfusion and FVLc defects, and the areas without defects. Patients could be classified as symptomatic or asymptomatic with an accuracy of 71% when fitting a regression model with these predictors on the entire dataset and their combined score was significantly different.
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