Fractional changes in lung capillary blood volume and oxygen saturation during the cardiac cycle in rabbits

Mapping cardiopulmonary dynamics within the microvasculature of the lungs using dissolved 129Xe MRI

Magnetic resonance (MR) imaging and spectroscopy using dissolved hyperpolarized (HP) 129Xe have expanded the ability to probe lung function regionally and noninvasively. In particular, HP 129Xe imaging has been used to quantify impaired gas uptake by the pulmonary tissues. Whole-lung spectroscopy has also been used to assess global cardiogenic oscillations in the MR signal intensity originating from 129Xe dissolved in the red blood cells of pulmonary capillaries. Herein, we show that the magnitude of these cardiogenic dynamics can be mapped three dimensionally using radial MRI, because dissolved 129Xe dynamics are encoded directly in the raw imaging data. Specifically, 1-point Dixon imaging is combined with postacquisition keyhole image reconstruction to assess regional blood volume fluctuations within the pulmonary microvasculature throughout the cardiac cycle. This "oscillation mapping" was applied in healthy subjects (mean amplitude 9% of total RBC signal) and patients with pulmonary arterial hypertension (PAH; mean 4%) and idiopathic pulmonary fibrosis (IPF; mean 14%). Whole-lung mean values from these oscillation maps correlated strongly with spectroscopy and clinical pulmonary function testing, but exhibited significant regional heterogeneity, including gravitationally dependent gradients in healthy subjects. Moreover, regional oscillations were found to be sensitive to disease state. Greater percentages of the lungs exhibit low-amplitude oscillations in PAH patients, and longitudinal imaging shows high-amplitude oscillations increase significantly over time (4-14 mo, P = 0.02) in IPF patients. This technique enables regional dynamics within the pulmonary capillary bed to be measured, and in doing so, provides insight into the origin and progression of pathophysiology within the lung microvasculature.NEW & NOTEWORTHY Spatially heterogeneous abnormalities within the lung microvasculature contribute to pathology in various cardiopulmonary diseases but are difficult to assess noninvasively. Hyperpolarized 129Xe MRI is a noninvasive method to probe lung function, including regional gas exchange between pulmonary air spaces and capillaries. We show that cardiogenic oscillations in the raw dissolved 129Xe MRI signal from pulmonary capillary red blood cells can be imaged using a postacquisition reconstruction technique, providing a new means of assessing regional lung microvasculature function and disease state.

Blue-green spectral minimum correlates with oxyhemoglobin saturation in vivo

An imaging multi-spectral retinal oximeter with intravitrial illumination is used to perform the first in vivo test of the blue-green minima shift oximetry method (BGO) in swine eyes [K. R. Dennighoff, R. A. Chipman, and L. W. Hillman, Opt. Lett. 31, 924-926 (2006); J. Biomed. Opt. 12, 034020 (2007).] A fiber optic intravitreal illuminator inserted through the pars plana was coupled to a monochromator and used to illuminate the retina from an angle. A camera viewing through the cornea recorded a series of images at each wavelength. This intravitreal light source moves the specular vessel glint away from the center of the vessel and directly illuminates the fundus behind most blood vessels. These two conditions combine to provide accurate measurements of vessel and perivascular reflectance. Equations describing these different light paths are solved, and BGO is used to evaluate large retinal vessels. In order to test BGO calibration in vivo, data were acquired from swine with varied retinal arterial oxyhemoglobin saturations (60-100% saturation.). The arterial saturations determined using BGO to analyze the multispectral image sets showed excellent correlation with co-oximeter data (r2=0.98, and residual error +/-3.4% saturation) and are similar to results when hemoglobin and blood were analyzed using this technique.

Increased surface tension decreases pulmonary capillary volume and compliance

Increased surface tension is an important component of several respiratory diseases, but its effects on pulmonary capillary mechanics are incompletely understood. We measured capillary volume and specific compliance before and after increasing surface tension with nebulized siloxane in excised dog lungs. The change in surface tension was sufficient to increase lung recoil 5 cm H(2)O at 50% total lung capacity. Increased surface tension decreased both capillary volume and specific compliance. The changes in capillary volume and compliance were greatest at the lung volumes at which the surface tension change was greatest. Near functional residual capacity, capillary volume postsiloxane was approximately 30% of control. Presiloxane capillary specific compliance was approximately 7%/cm H(2)O near functional residual capacity and approximately 2.5%/cm H(2)O near total lung capacity. Postsiloxane capillary-specific compliance was 3%/cm H(2)O, and was independent of lung volume. We conclude that in addition to their well-known effects on lung mechanics, changes in surface tension also have important effects on capillary mechanics. We speculate that these changes may in turn affect ventilation and perfusion, worsen gas exchange, and alter leukocyte sequestration.

Near-infrared spiroximetry: noninvasive measurements of venous saturation in piglets and human subjects

We present a noninvasive method to measure the venous oxygen saturation (Sv(O(2))) in tissues using near-infrared spectroscopy (NIRS). This method is based on the respiration-induced oscillations of the near-infrared absorption in tissues, and we call it spiroximetry (the prefix spiro means respiration). We have tested this method in three piglets (hind leg) and in eight human subjects (vastus medialis and vastus lateralis muscles). In the piglet study, we compared our NIRS measurements of the Sv(O(2)) (Sv(O(2))-NIRS(resp)) with the Sv(O(2)) of blood samples. Sv(O(2))-NIRS(resp) and Sv(O(2)) of blood samples agreed well over the whole range of Sv(O(2)) considered (20-95%). The two measurements showed an average difference of 1.0% and a standard deviation of the difference of 5.8%. In the human study, we found a good agreement between Sv(O(2))-NIRS(resp) and the Sv(O(2)) values measured with the NIRS venous occlusion method. Finally, in a preliminary test involving muscle exercise, Sv(O(2))-NIRS(resp) showed an expected postexercise decrease from the initial baseline value and a subsequent recovery to baseline.

Influence of lung volume on pulmonary microvascular pressure-volume characteristics

The pressure-volume (P-V) characteristics of the lung microcirculation are important determinants of the pattern of pulmonary perfusion and of red and white cell transit times. Using diffuse light scattering, we measured capillary P-V loops in seven excised perfused dog lobes at four lung volumes, from functional residual capacity (FRC) to total lung capacity (TLC), over a wide range of vascular transmural pressures (Ptm). At Ptm 5 cmH(2)O, specific compliance of the microvasculature was 8.6%/cmH(2)O near FRC, decreasing to 2.7%/cmH(2)O as lung volume increased to TLC. At low lung volumes, the vasculature showed signs of strain stiffening (specific compliance fell as Ptm rose), but stiffening decreased as lung volume increased and was essentially absent at TLC. The P-V loops were smooth without sharp transitions, consistent with vascular distension as the primary mode of changes in vascular volume with changes in Ptm. Hysteresis was small (0.013) at all lung volumes, suggesting that, although surface tension may set basal capillary shape, it does not strongly affect capillary compliance.