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BackgroundMRI of the lung is recommended in a number of clinical indications. Having a non-radiation alternative is particularly attractive in children and young subjects, or pregnant women.MethodsProvided there is sufficient expertise, magnetic resonance imaging (MRI) may be considered as the preferential modality in specific clinical conditions such as cystic fibrosis and acute pulmonary embolism, since additional functional information on respiratory mechanics and regional lung perfusion is provided. In other cases, such as tumours and pneumonia in children, lung MRI may be considered an alternative or adjunct to other modalities with at least similar diagnostic value.ResultsIn interstitial lung disease, the clinical utility of MRI remains to be proven, but it could provide additional information that will be beneficial in research, or at some stage in clinical practice. Customised protocols for chest imaging combine fast breath-hold acquisitions from a “buffet” of sequences. Having introduced details of imaging protocols in previous articles, the aim of this manuscript is to discuss the advantages and limitations of lung MRI in current clinical practice.ConclusionNew developments and future perspectives such as motion-compensated imaging with self-navigated sequences or fast Fourier decomposition MRI for non-contrast enhanced ventilation- and perfusion-weighted imaging of the lung are discussed.Main Messages• MRI evolves as a third lung imaging modality, combining morphological and functional information.• It may be considered first choice in cystic fibrosis and pulmonary embolism of young and pregnant patients.• In other cases (tumours, pneumonia in children), it is an alternative or adjunct to X-ray and CT.• In interstitial lung disease, it serves for research, but the clinical value remains to be proven.• New users are advised to make themselves familiar with the particular advantages and limitations.

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Type Scientific Poster Presentation Topic Pediatric RadiologyPurpose Cystic fibrosis (CF) is characterized by chronic respiratory infections and functional impairment of the lung. Lung function tests such as nitrogen multiple breath washout (N2-MBW), are sensitive in detecting ventilation inhomogeneity, but cannot determine its exact origin. Novel magnetic resonance imaging (MRI) methods such as matrix pencil decomposition MRI can visualize functional changes in the lung without the administration of contrast agents and the need for breathing maneuvers.Objectives: To examine the correlation between novel functional MRI and lung function tests in patients with CF. Methods and MaterialsMethods: Forty patients with CF (mean age 11.7 years, range 6-18) underwent MRI and lung function tests on the same day. Functional MRI provided semiquantitative measures of the perfusion (RQ) and ventilation (RFV) impairment as percentages of the affected lung volume. Morphological MRI was evaluated using a CF-specific score. N2-MBW provided information about global (lung clearance index, LCI) ventilation inhomogeneity. ResultsResults: MRI detected functional impairment in all patients with CF: RFV ranged from 19% to 38% and RQ ranged from 16% to 35%. RFV and RQ were strongly correlated with LCI (r=0.76, p<0.001; r=0.85, p<0.001, respectively), as well as total morphology scores and sub-scores. ConclusionConclusions: Non-invasive functional MRI is a promising method to detect and visualize perfusion and ventilation impairment in CF without the need of contrast agents or breath holding maneuvers. AffirmationsAuthors agreement: I confirm that all authors indicated within the author block of this abstract have been informed about this abstract submission and agreed to the same. (I confirm) Mandatory presenter registration: I understand that if the presenting author has not paid his registration fee by April 24, 2017, he will not be permitted to display the poster or hold the presentation and the abstract will not be published. (I agree)Copyright: I affirm that if my poster contains any material that has been previously published, I was entitled to use this material by applicable law or have obtained a transferable license from the copyright holder. (I confirm) Seite

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The purpose of this work was to validate ventilation-weighted (VW) and perfusion-weighted (QW) Fourier decomposition (FD) magnetic resonance imaging (MRI) with hyperpolarized (3)He MRI and dynamic contrast-enhanced perfusion (DCE) MRI in a controlled animal experiment. Three healthy pigs were studied on 1.5-T MR scanner. For FD MRI, the VW and QW images were obtained by postprocessing of time-resolved lung image sets. DCE acquisitions were performed immediately after contrast agent injection. (3)He MRI data were acquired following the administration of hyperpolarized helium and nitrogen mixture. After baseline MR scans, pulmonary embolism was artificially produced. FD MRI and DCE MRI perfusion measurements were repeated. Subsequently, atelectasis and air trapping were induced, which followed with FD MRI and (3)He MRI ventilation measurements. Distributions of signal intensities in healthy and pathologic lung tissue were compared by statistical analysis. Images acquired using FD, (3)He, and DCE MRI in all animals before the interventional procedure showed homogeneous ventilation and perfusion. Functional defects were detected by all MRI techniques at identical anatomical locations. Signal intensity in VW and QW images was significantly lower in pathological than in healthy lung parenchyma. The study has shown usefulness of FD MRI as an alternative, noninvasive, and easily implementable technique for the assessment of acute changes in lung function.

MP decomposition provides an automatic, robust, and more accurate estimation of amplitudes of respiratory and cardiac signal modulations in the lung parenchyma than the contemporary FD technique. Magn Reson Med 77:336-342, 2017. © 2016 Wiley Periodicals, Inc.

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