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Updated: Nov 26, 2025
Three-Dimensional Phase Resolved Functional Lung Magnetic Resonance Imaging
Published on: June 21, 2024
Functional respiratory imaging provides novel insights into the long-term respiratory sequelae of bronchopulmonary
Kristien Vanhaverbeke1,2, Monique Slaats3,2, Mohammed Al-Nejar4
1Laboratory for Experimental Medicine and Paediatrics, University of Antwerp, Antwerp, Belgium kristien.vanhaverbeke@uantwerpen.be.
Insights
Functional respiratory imaging (FRI) shows increased air trapping and distal airway resistance in adolescents with bronchopulmonary dysplasia (BPD). This advanced imaging may offer a more sensitive method for detecting long-term BPD complications in preterm infants.
Area of Science:
- Pulmonary Medicine
- Medical Imaging
- Pediatric Respiratory Health
Background:
- Bronchopulmonary dysplasia (BPD) is a prevalent complication following preterm birth, impacting lung development.
- Traditional assessments for BPD include lung function tests and imaging, but these may not fully capture the disease's complexity.
- Functional Respiratory Imaging (FRI) offers a novel approach by integrating structural and functional airway and vasculature assessments.
Purpose of the Study:
- To evaluate the utility of FRI in assessing BPD in adolescents with a history of preterm birth.
- To correlate FRI findings with clinical presentation and conventional imaging scores.
- To investigate the potential of FRI as a more sensitive tool for detecting BPD sequelae.
Main Methods:
- A cohort of 37 adolescents (22 with BPD, 15 preterm controls) underwent detailed history, lung function testing, and computed tomography (CT) scans at total lung capacity (TLC) and functional residual capacity (FRC).
- FRI analysis was performed on CT images, alongside assessment using the Aukland scoring system.
- Comparative analysis was conducted between BPD cases and preterm controls.
Main Results:
- BPD patients exhibited reduced forced expiratory volume in 1 second/forced vital capacity ratio and impaired diffusion capacity.
- FRI revealed significantly higher lobar volumes at FRC in BPD patients, indicative of air trapping, and increased distal airway resistance.
- Conventional Aukland CT scores did not differ between groups, whereas FRI identified more air trapping in BPD patients.
Conclusions:
- FRI demonstrates potential as a more sensitive method than conventional CT for detecting air trapping in BPD.
- The study highlights increased distal airway resistance as a key finding in adolescents with BPD.
- FRI's combined structural and functional assessment may enhance understanding of long-term BPD effects in preterm survivors.
Rationale:
Bronchopulmonary dysplasia (BPD) is a common complication of preterm birth. Lung function and imaging are classically used to assess BPD. Functional respiratory imaging (FRI) combines a structural and functional assessment of the airways and their vasculature. We aimed to assess BPD using FRI and to correlate these findings with the clinical presentation.
Methods:
We included 37 adolescents with a history of preterm birth (22 BPD cases and 15 preterm controls). The study protocol included a detailed history, lung function testing and computed tomography (CT) (at total lung capacity (TLC) and functional residual capacity (FRC)) with FRI. CT images were also assessed using the Aukland scoring system.
Results:
BPD patients had lower forced expiratory volume in 1 s to forced vital capacity ratio (p=0.02) and impaired diffusion capacity (p=0.02). Aukland CT scores were not different between the two groups. FRI analysis showed higher lobar volumes in BPD patients at FRC (p<0.01), but not at TLC. Airway resistance was significantly higher in the BPD group, especially in the distal airways. Additionally, FRI showed more air trapping in BPD patients, in contrast to findings on conventional CT images.
Conclusion:
This study is the first to use FRI in research for BPD. FRI analysis showed higher lobar volumes in BPD patients, indicating air trapping and reduced inspiratory capacity. In contrast to Aukland CT scores, FRI showed more air trapping in the BPD group, suggesting that FRI might be a more sensitive detection method. Importantly, we also showed increased distal airway resistance in BPD patients. By combining structural and functional assessment, FRI may help to better understand the long-term sequelae of BPD.
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