What is the role of MRI in the workup of emphysema?

Updated: Mar 13, 2019
  • Author: Ali Nawaz Khan, MBBS, FRCS, FRCP, FRCR; Chief Editor: Eugene C Lin, MD  more...
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Hyperpolarized gases are contrast agents that, when inhaled, provide images of the lung airspaces with high temporal and spatial resolution. The availability of these gases has great potential in the study of diffuse lung disease, particularly emphysema. [45]

Preoperative dynamic MRI has been studied as an additional outcome predictor for patient selection in LVRS. [46]

Ley et al assessed emphysematous enlargement of distal airspaces and concomitant large- and small-airway disease by using diffusion-weighted helium MRI, high-resolution CT (HRCT), and lung function tests. Helium MRI and HRCT scanning showed better agreement than did HRCT scanning results and functional characterizations of emphysema in terms of hyperinflation and large- and small-airway disease, as assessed on lung function tests. [47]

Sergiacomi et al [48] used lung-perfusion 2-dimensional (2D) dynamic breath-hold technique in patients with severe emphysema and found a high sensitivity (86.7%) and good specificity (80.0%) in detecting perfusion defects. They observed low peak signal intensities in emphysematous regions and concluded that lung perfusion MRI is a potential alternative to nuclear medicine study in the evaluation of severe pulmonary emphysema.

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