Measurement of total lung water from nuclear magnetic resonance images

An accurate, non-invasive means of measuring pulmonary water is desirable, for both clinical and research use. Nuclear magnetic resonance imaging is theoretically very suitable for this purpose. Nuclear magnetic resonance (NMR) spectroscopy was used to show that the water content of lung tissue could be predicted accurately from the intensity of signal resulting from a 90 degree saturation recovery sequence. The water contained in an image section may, therefore, be calculated by reference to a 100% water standard. Lung water was obtained by imaging the lung in continuous sections and summing the water contents of the component sections. The method performed well when applied to a sponge phantom, but underestimated by up to 30% in excised sheep lung. The total (vascular and extravascular) pulmonary water measured by NMR in six healthy volunteers was 292 g (SD 58 g) or 4.6 g/kg body weight, less than predicted by some other indirect methods and post-mortem values. A briefer examination comprising two axial sections at standardised levels was also devised. In 15 healthy volunteers the mean water content of a 1.6 cm-thick axial section through the right lung was 17.8 g at the sternal angle, and 23.3 g 5 cm caudally. In the left lung, the values were 16.4 g and 16.3 g, respectively.