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From the Department of Medicine, Robert Wood Johnson School of Medicine, University of Medicine and Dentistry of New Jersey, Cooper University Hospital, Camden, New Jersey.
Address correspondence to R. Phillip Dellinger, MD, Division of Critical Care Medicine, Cooper University Hospital, One Cooper Plaza, Dorrance Bldg Ste 393, Camden, NJ 08103. Address e-mail to dellinger-phil{at}cooperhealth.edu.
BACKGROUND: Vibration response imaging (VRI) is a computer-based technology that creates a visual dynamic two-dimensional image of distribution of vibration within the lung during the respiratory process. The acoustic signals, recorded from 36 posteriorly positioned surface skin sensors, are transferred to a hardware board where several stages of filtering are applied to select a specific frequency band. The filtered output signal frequencies are presented as a gray-scale coded dynamic image, consisting of a series of 0.17 s frames, and as a table featuring the percentage contribution of each lung to the total vibration signal.
METHODS: We describe the VRI technology in detail and examine images obtained from consecutive intensive care unit (ICU) patients with one diseased lung on chest radiograph. ICU patients with normal chest radiographs are presented as controls. Analysis of the image was performed by comparing the weighted pixel count analysis from both lungs. In this method, the pixels in the image were assigned values based on their grayscale color with the darker pixels assigned higher values.
RESULTS: In patients with normal chest radiographs, the right and left lungs developed similarly in dynamic VRI images, and the percent lung vibrations from both sides were comparable (53% ± 12% and 47% ± 12%, respectively). In ICU patients with asymmetric lung disease, however, the percent lung vibrations from the diseased and nondiseased lungs were 27% ± 23% and 73% ± 23%, respectively (P < 0.001). In patients with asymmetric lung disease (one lung has moderate to severe disease and the other appears normal or close to normal as per chest radiograph), the diseased lung usually appeared in VRI as irregular, smaller, and lighter in color (reduced vibration signal) when compared to the nonaffected lung. The weighted pixel count from diseased and nondiseased lungs were 33% ± 21% and 67% ± 21%, respectively (P < 0.003).
CONCLUSION: The VRI technology may provide a radiation-free method for identifying and tracking of asymmetric lung parenchymal processes.
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