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INVITED REVIEW

HIGHLIGHTED TOPIC
Physiological Imaging of the Lung

Advances in magnetic resonance imaging of lung physiology

Departments of ¹Medicine and ²Radiology, University of California, San Diego, La Jolla, California; and ³Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania

This review presents an overview of some recent magnetic resonance imaging (MRI) techniques for measuring aspects of local physiology in the lung. MRI is noninvasive, relatively high resolution, and does not expose subjects to ionizing radiation. Conventional MRI of the lung suffers from low signal intensity caused by the low proton density and the large degree of microscopic field inhomogeneity that degrades the magnetic resonance signal and interferes with image acquisition. However, in recent years, there have been rapid advances in both hardware and software design, allowing these difficulties to be minimized. This review focuses on some newer techniques that measure regional perfusion, ventilation, gas diffusion, ventilation-to-perfusion ratio, partial pressure of oxygen, and lung water. These techniques include contrast-enhanced and arterial spin-labeling techniques for measuring perfusion, hyperpolarized gas techniques for measuring regional ventilation, and apparent diffusion coefficient and multiecho and gradient echo techniques for measuring proton density and lung water. Some of the major advantages and disadvantages of each technique are discussed. In addition, some of the physiological issues associated with making measurements are discussed, along with strategies for understanding large and complex data sets.

hyperpolarized helium-3 magnetic resonance imaging; regional ventilation; regional perfusion; apparent diffusion coefficient; ventilation-perfusion ratio; regional lung water

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