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Updated: Sep 29, 2025
Three-Dimensional Phase Resolved Functional Lung Magnetic Resonance Imaging
Published on: June 21, 2024
School-age structural and functional MRI and lung function in children following lung resection for congenital lung
Corin Willers1, Lukas Maager1, Grzegorz Bauman2,3
1Division of Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 8, 3010, Bern, Switzerland.
Insights
Functional MRI reveals localized decreases in ventilation and perfusion in the remaining lung after congenital lung malformation surgery. These findings, missed by standard tests, highlight the need for functional MRI in pediatric lung care.
Area of Science:
- Pediatric Pulmonology
- Medical Imaging
- Thoracic Surgery
Background:
- Management of asymptomatic congenital lung malformations remains debated.
- Limited data exists on long-term lung growth post-resection for congenital lung malformations.
- Novel functional MRI techniques were employed to assess lung perfusion and ventilation.
Purpose of the Study:
- To evaluate the functionality of the remaining lung tissue after surgical resection of congenital lung malformations.
- To assess lung expansion and compensatory growth in children post-surgery.
Main Methods:
- A prospective, cross-sectional pilot study involving five children who underwent surgery for congenital lung malformations in infancy.
- Utilized structural and functional magnetic resonance imaging (MRI), spirometry, body plethysmography, and multiple breath washout at school age.
Main Results:
- Structural MRI demonstrated lung expansion in all participants.
- Functional MRI indicated locally decreased fractional ventilation and relative perfusion in the expanded lung segments.
- An association was observed between impaired perfusion and an elevated lung clearance index; spirometry results varied, showing normal function, restriction, or obstruction.
Conclusions:
- Functional MRI effectively identifies localized impairments in ventilation and perfusion post-lung resection, which are not detected by conventional methods.
- These functional deficits in the remaining lung warrant systematic investigation using functional lung MRI in children following surgery for congenital lung malformations.
Background:
The management of asymptomatic congenital lung malformations is debated. Particularly, there is a lack of information regarding long-term growth and development of the remaining lung in children following lung resection for congenital lung malformations. In addition to conventional pulmonary function tests, we used novel functional magnetic resonance imaging (MRI) methods to measure perfusion and ventilation.
Objective:
To assess functionality of the remaining lung expanded into the thoracic cavity after resection of congenital lung malformations.
Materials And Methods:
A prospective, cross-sectional pilot study in five children who had surgery for congenital lung malformations during infancy. Participants had structural and functional MRI as well as spirometry, body plethysmography and multiple breath washout at school age.
Results:
Structural MRI showed an expansion of the remaining lung in all cases. Fractional ventilation and relative perfusion of the expanded lung were locally decreased in functional MRI. In all other parts of the lungs, fractional ventilation and relative perfusion were normal in all children. There was an association between overall impairment of perfusion and elevated lung clearance index. The results of spirometry and body plethysmography varied between patients, including normal lung function, restriction and obstruction.
Conclusion:
Fractional ventilation and relative perfusion maps from functional MRI specifically locate impairment of the remaining lung after lung resection. These changes are not captured by conventional measures such as structural MRI and standard pulmonary function tests. Therefore, following lung resection for congenital lung malformation, children should be investigated more systematically with functional lung MRI.
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