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Electrical impedance tomography reveals ventilation and perfusion heterogeneity in infants with bronchopulmonary dysplasia

Journal of Perinatology (2026)Cite this article

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Abstract

Objective

Preterm infants have pulmonary ventilation and perfusion abnormalities, yet few imaging modalities can inform clinicians about this ventilation/perfusion (V/Q) relationship. Electrical impedance tomography (EIT) is an imaging technique with V/Q imaging capabilities that has not been well described in infants with BPD.

Study design

EIT was performed every 4 weeks in preterm infants for a maximum of 5 visits per infant. Term infants with healthy lungs had one EIT imaging visit as controls.

Results

Data were collected from a total of 51 EIT visits. Novel V/Q maps were generated from each visit. Ventilation heterogeneity (measured by the global inhomogeneity index) and V/Q heterogeneity (measured by coefficient of variation of V/Q maps) were significantly higher in preterm infants at the visit closest to 36 weeks post-menstrual age than controls (p = 0.002 and p = 0.039, respectively).

Conclusions:

Pulmonary ventilation, perfusion, and V/Q relationship can be quantified by EIT, and may be indicators of chronic lung disease.

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Fig. 1: Timeline of EIT imaging by post-menstrual age (PMA).
Fig. 2: Representative EIT ventilation, perfusion, and V/Q map images for study patients.
Fig. 3: Global inhomogeneity (GI) index and Coefficient of variation of V/Q maps (CO(VQmap))in preterm and control infants.

Data availability

Statement: The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

Thank you to our patients and their families who generously agreed to participate in this study.

Author information

Authors and Affiliations

  1. Department of Pediatrics, Section of Pulmonary and Sleep Medicine, University of Colorado, Aurora, CO, USA

    Katelyn G. Enzer, Allison Keck & Christopher D. Baker

  2. School of Biomedical Engineering, Colorado State University, Fort Collins, CO, USA

    Nilton Barbosa Da Rosa Jr

  3. Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA

    Ella Hagopian

  4. Department of Pediatrics, Section of Endocrinology, Child Health Biostatistics Core, University of Colorado School of Medicine, Aurora, CO, USA

    John T. Brinton

  5. Department of Electrical & Computer Engineering, University at Albany, SUNY, Albany, NY, USA

    Omid Rajabi Shishvan & Gary Saulnier

  6. Rensselaer Polytechnic Institute, Troy, NY, USA

    David Isaacson

  7. Department of Mathematics and School of Biomedical Engineering, Colorado State University, Fort Collins, CO, USA

    Jennifer L. Mueller

Authors
  1. Katelyn G. Enzer
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  2. Nilton Barbosa Da Rosa Jr
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  3. Allison Keck
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  6. Omid Rajabi Shishvan
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  10. Christopher D. Baker
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Contributions

KGE: research conception and design, data acquisition, data analysis, drafting of manuscript, critical revision of manuscript; NBD: data acquisition, data analysis, critical revision of manuscript; AK: data acquisition, critical revision of manuscript; EH: data analysis, critical revision of manuscript; JTB: data analysis, critical revision of manuscript; ORS: data analysis, critical revision of manuscript; GS: data analysis, critical revision of manuscript; DI: data analysis, critical revision of manuscript; JLM: research conception and design, data acquisition, data analysis, drafting of manuscript, critical revision of manuscript; CDB: research conception and design, data analysis, drafting of manuscript, critical revision of manuscript

Corresponding author

Correspondence to Katelyn G. Enzer.

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Competing interests

The authors declare no competing interests.

Ethics approval

The study was approved by the Colorado Multiple Institutional Review Board (#18-1843) and informed consent was obtained from all subjects. All methods were performed in accordance with relevant regulations.

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Enzer, K.G., Barbosa Da Rosa, N., Keck, A. et al. Electrical impedance tomography reveals ventilation and perfusion heterogeneity in infants with bronchopulmonary dysplasia. J Perinatol (2026). https://doi.org/10.1038/s41372-026-02590-4

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