British Journal of Anaesthesia, 2003, Vol. 91, No. 1 16-30
© 2003 The Board of Management and Trustees of the British Journal of Anaesthesia
Review Article |
Functional magnetic resonance imaging of the lung
1 Unit of Academic Anaesthesia, University of Sheffield and The Directorate of Critical Care Medicine, Royal Hallamshire Hospital, Glossop Road, Sheffield, S10 2JF UK. 2 Unit of Academic Radiology, University of Sheffield, Royal Hallamshire Hospital, Sheffield, UK. 3 Dept of Anaesthesiology, Johannes Gutenberg University School of Medicine, Mainz, Germany
Corresponding author. E-mail: G.H.Mills@sheffield.ac.uk
Keywords: anaesthetics gases, xenon; gases non-anaesthetic, helium; measurement techniques, magnetic resonance imaging; oxygen, regional intrapulmonary
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Limited imaging of lung function is possible with methods that use ionizing radiation, such as computed tomography (CT) and lung scintigraphy. Methods using magnetic resonance (MR) are preferable because they do not involve ionizing radiation. At first, MR methods were difficult because of the lack of protons and artefacts caused by inhomogeneity in the lungs. Recently, new techniques have allowed static and dynamic lung imaging with MR. We discuss the methods that allow functional imaging of the lung and describe new developments in functional MR imaging (MRI). From being almost invisible to MRI, lung images with MR may soon radically affect the way we assess the function of the lung and the pulmonary circulation.
Techniques available to functionally image the lung
The first attempts to obtain functional information of the lungs date back to the early days of x-ray fluoroscopy. However, these concentrated on the tissues and structures surrounding the lung. Fluoroscopy could show diaphragm motion during
Nuclear medicine and scintigraphy
Electrical impedance tomography (EIT)
Computerized tomography
MRI of the lungs
Basic theory of MRI
Use of proton MRI in the lung
Oxygen-enhanced 1H MRI
Contrast agents
MRI with noble gases
SE optical pumping
ME optical pumping
Technical aspects of hyperpolarized-gas MRI
Administering hyperpolarized 3He
Single-breath static distribution of ventilation in normal subjects, smokers and patients with asthma, cystic fibrosis and COPD
Regional volumetric imaging with hyperpolarized 3He
Apparent diffusion coefficient (ADC) measurements with 3He
Dynamic ventilation MRI with 3He
Intrapulmonary measurement of PO2 with 3He MR
Low/ultra-low field imaging with 3He
3He microbubbles and vascular imaging
Hyperpolarized xenon
Lung imaging with 19F
Conclusion
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