[Reformation as proposed solution for the problem of sectioning different levels with 3He-MRT and HR-CT of the chest]

[Functional 3He-MRI of the lungs]

Pulmonary diseases have a high health-related and economic significance. (3)He-MRI is an alternative imaging method which can detect ventilatory disturbances with a high sensitivity. The application of different pulse sequences allows static and dynamic assessment of ventilation and bronchial gas flow, non-invasive measurement of intrapulmonary oxygen partial pressure and quantification of pulmonary parenchyma destruction and overinflation. Generally, the method is applicable for obstructive and restrictive ventilatory disturbances but initial approaches also exist for vascular pulmonary diseases. Specific clinical applications remain to be determined but (3)He-MRI is an excellent instrument for the assessment of physiologic and pathophysiologic interrelations in the distribution of ventilation.

Oxygen-sensitive 3He-MRI in bronchiolitis obliterans after lung transplantation

Oxygen-sensitive 3He-MRI was studied for the detection of differences in intrapulmonary oxygen partial pressure (pO2) between patients with normal lung transplants and those with bronchiolitis obliterans syndrome (BOS). Using software developed in-house, oxygen-sensitive 3He-MRI datasets from patients with normal lung grafts (n = 8) and with BOS (n = 6) were evaluated quantitatively. Datasets were acqiured on a 1.5-T system using a spoiled gradient echo pulse sequence. Underlying diseases were pulmonary emphysema (n = 10 datasets) and fibrosis (n = 4). BOS status was verified by pulmonary function tests. Additionally, 3He-MRI was assessed blindedly for ventilation defects. Median intrapulmonary pO2 in patients with normal lung grafts was 146 mbar compared with 108 mbar in patients with BOS. Homogeneity of pO2 distribution was greater in normal grafts (standard deviation pO2 34 versus 43 mbar). Median oxygen decrease rate during breath hold was higher in unaffected patients (-1.75 mbar/s versus -0.38 mbar/s). Normal grafts showed fewer ventilation defects (5% versus 28%, medians). Oxygen-sensitive 3He-MRI appears capable of demonstrating differences of intrapulmonary pO2 between normal lung grafts and grafts affected by BOS. Oxygen-sensitive 3He-MRI may add helpful regional information to other diagnostic techniques for the assessment and follow-up of lung transplant recipients.

Two-dimensional and three-dimensional oxygen mapping by 3He-MRI validation in a lung phantom

The aim of this study was to validate oxygen-sensitive 3He-MRI in noninvasive determination of the regional, two- and three-dimensional distribution of oxygen partial pressure. In a gas-filled elastic silicon ventilation bag used as a lung phantom, oxygen sensitive two- and three-dimensional 3He-MRI measurements were performed at different oxygen concentrations which had been equilibrated in a range of normal and pathologic values. The oxygen partial pressure distribution was determined from 3He-MRI using newly developed software allowing for mapping of oxygen partial pressure. The reference bulk oxygen partial pressure inside the phantom was measured by conventional respiratory gas analysis. In two-dimensional measurements, image-based and gas-analysis results correlated with r=0.98; in three-dimensional measurements the between-methods correlation coefficient was r=0.89. The signal-to-noise ratio of three-dimensional measurements was about half of that of two-dimensional measurements and became critical (below 3) in some data sets. Oxygen-sensitive 3He-MRI allows for noninvasive determination of the two- and three-dimensional distribution of oxygen partial pressure in gas-filled airspaces.

Magnetic resonance imaging using hyperpolarized 3He-gas1

RATIONALE AND OBJECTIVES

Current imaging procedures of the lung concentrate on visualization of morphology. Computed tomography is the imaging method of choice for the majority of pulmonary diseases. Functional data are commonly obtained from arterial blood gas analysis, spirometry, and body plethysmography, which all suffer from lack of regional information.

MATERIALS AND METHODS

Magnetic resonance imaging (MRI) of the lung has been advanced recently by the use of hyperpolarized 3He as a new contrast mechanism. Four different image acquisition modes are performed during a typical patient study.

RESULTS

3He-MRI yields functional information about the lung with a high spatial and temporal resolution, avoiding the risks of ionizing radiation. The method is currently limited by high costs and restricted availability of the gas.

CONCLUSION

In this article, the experience obtained at the University of Mainz, being Europe's most experienced center performing 3He-MRI in humans, is reviewed against the international background.