Feasibility of quantitative regional ventilation and perfusion mapping with phase‐resolved functional lung (PREFUL) MRI in healthy volunteers and COPD, CTEPH, and CF patients

• Published in: Magnetic resonance in medicine Vol. 79; no. 4; pp. 2306 - 2314
• Main Authors: Voskrebenzev, Andreas, Gutberlet, Marcel, Klimeš, Filip, Kaireit, Till F., Schönfeld, Christian, Rotärmel, Alexander, Wacker, Frank, Vogel‐Claussen, Jens
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.04.2018
• Subjects: Chronic obstructive pulmonary disease; Computed tomography; Cystic fibrosis; Emphysema; Feasibility studies; Fourier decomposition; Functional magnetic resonance imaging; Heart; Heart diseases; high temporal resolution; Hypertension; Hypoventilation; Image acquisition; Image reconstruction; lung; Lung diseases; Magnetic resonance imaging; Mechanical ventilation; Obstructive lung disease; Patients; Perfusion; pulmonary MRI; Surgery; Temporal resolution; Thromboembolism; Ventilation; lung; pulmonary MRI; Fourier decomposition; high temporal resolution
• ISSN: 0740-3194; 1522-2594
• DOI: 10.1002/mrm.26893

Purpose In this feasibility study, a phase‐resolved functional lung imaging postprocessing method for extraction of dynamic perfusion (Q) and ventilation (V) parameters using a conventional 1H lung MRI Fourier decomposition acquisition is introduced. Methods Time series of coronal gradient‐echo MR images with a temporal resolution of 288 to 324 ms of two healthy volunteers, one patient with chronic thromboembolic hypertension, one patient with cystic fibrosis, and one patient with chronic obstructive pulmonary disease were acquired at 1.5 T. Using a sine model to estimate cardiac and respiratory phases of each image, all images were sorted to reconstruct full cardiac and respiratory cycles. Time to peak (TTP), V/Q maps, and fractional ventilation flow‐volume loops were calculated. Results For the volunteers, homogenous ventilation and perfusion TTP maps (V‐TTP, Q‐TTP) were obtained. The chronic thromboembolic hypertension patient showed increased perfusion TTP in hypoperfused regions in visual agreement with dynamic contrast‐enhanced MRI, which improved postpulmonary endaterectomy surgery. Cystic fibrosis and chronic obstructive pulmonary disease patients showed a pattern of increased V‐TTP and Q‐TTP in regions of hypoventilation and decreased perfusion. Fractional ventilation flow‐volume loops of the chronic obstructive pulmonary disease patient were smaller in comparison with the healthy volunteer, and showed regional differences in visual agreement with functional small airways disease and emphysema on CT. Conclusions This study shows the feasibility of phase‐resolved functional lung imaging to gain quantitative information regarding regional lung perfusion and ventilation without the need for ultrafast imaging, which will be advantageous for future clinical translation. Magn Reson Med 79:2306–2314, 2018. © 2017 International Society for Magnetic Resonance in Medicine.