Imaging lung aeration and lung liquid clearance at birth using phase contrast X-ray imaging.

The transition to extra-uterine life at birth is critically dependent on airway liquid clearance to allow the entry of air and the onset of gaseous ventilation. We have used phase contrast X-ray imaging to identify factors that regulate lung aeration at birth in spontaneously breathing term and mechanically ventilated preterm rabbit pups. Phase contrast X-ray imaging exploits the difference in refractive index between air and water to enhance image contrast, enabling the smallest air-filled structures of the lung (alveoli; < 100 microm) to be resolved. Using this technique, the lungs become visible as they aerate, allowing the air-liquid interface to be observed as it moves distally during lung aeration. Spontaneously breathing term rabbit pups rapidly aerate their lungs, with most fully recruiting their functional residual capacity (FRC) within the first few breaths. The increase in FRC occurs mainly during individual breaths, demonstrating that airway liquid clearance and lung aeration is closely associated with inspiration. We suggest that transpulmonary pressures generated by inspiration provide a hydrostatic pressure gradient for the movement of water out of the airways and into the surrounding lung tissue after birth. In mechanically ventilated preterm pups, lung aeration is closely associated with lung inflation and a positive end-expiratory pressure is required to generate and maintain FRC after birth. In summary, phase contrast X-ray imaging can image the air-filled lung with high temporal and spatial resolution and is ideal for identifying factors that regulate lung aeration at birth in both spontaneously breathing term and mechanically ventilated preterm neonates.

Simultaneous acquisition of dual analyser-based phase contrast X-ray images for small animal imaging.

Analyser-based phase contrast X-ray imaging can provide high-contrast images of biological tissues with exquisite sensitivity to the boundaries between tissues. The phase and absorption information can be extracted by processing multiple images acquired at different analyser orientations. Recording both the transmitted and diffracted beams from a thin Laue analyser crystal can make phase retrieval possible for dynamic systems by allowing full field imaging. This technique was used to image the thorax of a mechanically ventilated newborn rabbit pup using a 25 keV beam from the SPring-8 synchrotron radiation facility. The diffracted image was produced from the (111) planes of a 50 mm x 40 mm, 100 microm thick Si analyser crystal in the Laue geometry. The beam and analyser were large enough to image the entire chest, making it possible to observe changes in anatomy with high contrast and spatial resolution.