Long-term effects in adulthood on lung development of preterm birth: An ultra-short echo time magnetic resonance imaging investigation

RATIONALE Pulmonary magnetic resonance imaging (MRI) using ultra-short echo time (UTE) is a radiation-free biomarker which could be used for early identification of lung disease.OBJECTIVE The objectives of this study were to determine whether 1H UTE MRI can be used as a biomarker to identify pulmonary abnormalities in adults born extremely preterm, ≤28 wk gestational age and adults born term and to explore the association between the 1H UTE MRI finding and pulmonary function tests (PFTs).METHODS Adults aged 18–29 years born extremely preterm between 1987 and 1997 were recruited in a single center. Participants underwent 1H UTE MRI at full inspiration (FI), full expiration (FE), functional residual volume (FRC) and FRC + 1 L. The primary outcome was the MRI signal intensity (SI) at each lung volume. PFT measurements were performed by participants.RESULTS Adults born preterm (n = 18) had a significantly greater SI at FE (median 43 (IQR 39.2-57.6) vs 37.8 (33.4-39.7), p = 0.008) compared to adults born term (n = 14). In addition to a moderate correlation between SIFRC and total lung capacity (TLC)%pred, weak correlations between SI and PFT values were observed.CONCLUSION Significantly greater SI at FE identified in adults born preterm suggest lesser air possibly reflecting areas of atelectasis in the preterm group. Identification and quantification of lung MRI biomarkers in individuals born preterm highlight the need to further investigate their potential role to inform targeted preventive or early therapeutic approaches.