Functional Thoracic MRI: Recent Advances in Pulmonary Assessment

Area of Science:

• Radiology
• Pulmonary Medicine
• Medical Imaging

Background:

• Pulmonary function tests (PFTs) like spirometry provide only global lung function measurements.
• There is a need for advanced imaging techniques that offer regional assessment of lung function.

Purpose of the Study:

• To review recent advances in functional thoracic MRI for regional lung function and pathophysiology evaluation.
• To highlight the advantages of MRI over traditional PFTs.

Main Methods:

• Utilizing various contrast mechanisms and gas agents for lung ventilation assessment.
• Employing perfusion imaging (with or without contrast) for mechanical lung properties.
• Applying advanced MRI techniques for distal airspace and gas exchange quantification using noble gases.
• Leveraging dynamic contrast-enhanced perfusion MRI for pathophysiologic mechanism assessment.

Main Results:

• Functional thoracic MRI enables regional assessment of ventilation, perfusion, and gas exchange.
• MRI evaluates respiratory mechanics, including chest wall and diaphragm motion, and airway dynamics.
• Advanced techniques quantify airspace dimensions and diffusion capacity.
• Dynamic MRI visualizes ventilation-perfusion mismatch and mechanisms like hypoxic pulmonary vasoconstriction.

Conclusions:

• Functional thoracic MRI provides comprehensive regional lung function evaluation.
• Emerging non-contrast techniques show promise for clinical translation.
• MRI offers a powerful tool for understanding respiratory pathophysiology in various lung diseases.