For the first time, advanced MR imaging techniques were used in premature infants born before 32 weeks of gestation to demonstrate the synergistic power of changes in PA flow and cardiac function under consideration of prematurity at the time of BPD diagnosis to detect pulmonary vascular pathology. The characteristic changes in PA blood flow and cardiac function were successfully linked to increasing pressure in the pulmonary circulation, likely stemming from a rarefied and remodeled vascular bed. In the very heterogeneous group of infants with milder BPD, the algorithm successfully identified those cases with a significant risk for PVD.

The Non-invasive Diagnostic Strategy Can Be Easily Applied in Clinics
The early detection of signs of PVD in premature infants with BPD using MRI harbors the possibility of categorizing premature infants into different risk levels for PVD and subsequent PH development and even sudden cardiac death in later life. The non-invasive nature of the newly presented diagnostic strategy and the potential to use highly standardized protocols in spontaneously sleeping infants makes this method suitable for clinical application. Future studies will track the identified, early signs of lung vascular pathology into (pre)school age and adulthood to evaluate risk-adapted monitoring and treatment strategies in BPD.


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