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Updated: Jul 11, 2025
Three-Dimensional Phase Resolved Functional Lung Magnetic Resonance Imaging
Published on: June 21, 2024
Functional lung imaging of 2-year-old children after congenital diaphragmatic hernia repair using dynamic mode
Efe Ilicak1,2, Greta Thater3, Safa Ozdemir4,5
1Computer Assisted Clinical Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany. efe.ilicak@medma.uni-heidelberg.de.
Insights
Non-contrast-enhanced functional MRI using dynamic mode decomposition (DMD) shows promise for assessing lung function in children after congenital diaphragmatic hernia (CDH) repair. This technique provides ventilation and perfusion maps without radiation or contrast agents, correlating well with traditional methods.
Area of Science:
- Medical Imaging
- Pediatric Radiology
- Pulmonary Medicine
Background:
- Congenital diaphragmatic hernia (CDH) repair requires monitoring of lung function.
- Traditional imaging methods may involve ionizing radiation or contrast agents.
- Non-contrast-enhanced functional lung imaging is desirable for pediatric patients.
Purpose of the Study:
- To evaluate the feasibility of non-contrast-enhanced functional lung imaging in 2-year-old children post-CDH repair.
- To assess pulmonary ventilation and perfusion using dynamic mode decomposition (DMD) MRI.
- To compare DMD MRI findings with contrast-enhanced MRI.
Main Methods:
- Fifteen pediatric patients after CDH repair underwent non-contrast-enhanced dynamic MRI with two protocols (high temporal and high spatial resolution).
- Dynamic mode decomposition (DMD) analysis was used to generate ventilation (V) and perfusion (Q) maps.
- Ventilation and perfusion ratios (VRatio, QRatio) were calculated and compared between ipsilateral and contralateral lungs.
- DMD MRI perfusion results were correlated with dynamic contrast-enhanced (DCE) MRI parameters.
Main Results:
- Both MRI protocols successfully generated V and Q maps in all patients.
- Reduced ipsilateral lung ventilation and perfusion were observed (VRatio ≈ 0.84-0.88, QRatio ≈ 0.70-0.72).
- A strong positive correlation and close agreement were found between DMD MRI and DCE MRI perfusion parameters.
Conclusions:
- Non-contrast-enhanced DMD MRI is a feasible method for functional lung imaging in pediatric CDH patients.
- This technique provides pulmonary ventilation and perfusion information without ionizing radiation or contrast agents.
- DMD MRI offers a promising, safe alternative for monitoring lung function in CDH survivors.
Objectives:
To investigate the feasibility of non-contrast-enhanced functional lung imaging in 2-year-old children after congenital diaphragmatic hernia (CDH) repair.
Methods:
Fifteen patients after CDH repair were examined using non-contrast-enhanced dynamic magnetic resonance imaging (MRI). For imaging two protocols were used during free-breathing: Protocol A with high temporal resolution and Protocol B with high spatial resolution. The dynamic images were then analysed through a recently developed post-processing method called dynamic mode decomposition (DMD) to obtain ventilation and perfusion maps. The ventilation ratios (VRatio) and perfusion ratios (QRatio) of ipsilateral to contralateral lung were compared to evaluate functional differences. Lastly, DMD MRI-based perfusion results were compared with perfusion parameters obtained using dynamic contrast-enhanced (DCE) MRI to assess agreement between methods.
Results:
Both imaging protocols successfully generated pulmonary ventilation (V) and perfusion (Q) maps in all patients. Overall, the VRatio and QRatio values were 0.84 ± 0.19 and 0.70 ± 0.24 for Protocol A, and 0.88 ± 0.18 and 0.72 ± 0.23 for Protocol B, indicating reduced ventilation ( ) and perfusion ( ) on the ipsilateral side. Moreover, there is a very strong positive correlation ( ) and close agreement between DMD MRI-based perfusion values and DCE MRI-based perfusion parameters.
Conclusions:
DMD MRI can obtain pulmonary functional information in 2-year-old CDH patients. The results obtained with DMD MRI correlate with DCE MRI, without the need for ionising radiation or exposure to contrast agents. While further studies with larger cohorts are warranted, DMD MRI is a promising option for functional lung imaging in CDH patients.
Clinical Relevance Statement:
We demonstrate that pulmonary ventilation and perfusion information can be obtained in 2-year-old patients after CDH repair, without the need for ionising radiation or contrast agents by utilising non-contrast-enhanced MRI acquisitions together with dynamic mode decomposition analysis.
Key Points:
• Non-contrast-enhanced functional MR imaging is a promising option for functional lung imaging in 2-year-old children after congenital diaphragmatic hernia. • DMD MRI can generate pulmonary ventilation and perfusion maps from free-breathing dynamic acquisitions without the need for ionising radiation or contrast agents. • Lung perfusion parameters obtained with DMD MRI correlate with perfusion parameters obtained using dynamic contrast-enhanced MRI.
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