C/RL-r is more accurate for diagnosing cirrhosis and evaluating its clinical severity than is C/RL-m.

A synovial fold extending from the posterior fat pad in the elbow is a frequent finding on MR imaging. In a subgroup of patients, plicae, when thickened, may present clinically as a locking elbow. However, overlap exists between the thicknesses of symptomatic and asymptomatic plicae.

To evaluate impaired respiratory mechanics in pulmonary emphysema, dynamic breathing magnetic resonance imaging (BMRI) was acquired with fast‐gradient echo pulse sequences at fixed thoracic planes over two to three slow, deep respiratory cycles in 6 controls and 28 patients with pulmonary emphysema including 9 patients undergoing lung volume reduction surgery (LVRS). Respiratory motions of the diaphragm and chest wall (D/CW) were assessed by a cineloop view, a fusion display of maximal inspiratory and expiratory images, and the time‐distance curves. By contrast with normal subjects with regular synchronous D/CW motions, the patients frequently showed reduced, irregular, or asynchronous motions, with significant decreases in the maximal amplitude of D/CW motions (MAD and MACW), and the length of apposition of the diaphragm (LAD) (P < 0.0001, P < 0.001, P < 0.01, respectively). After LVRS, nine patients showed improvements in D/CW configuration and mobility, with significantly increased MAD, MACW, and LAD (P < 0.01, P < 0.0001, and P < 0.05, respectively). In 40 studies of 28 patients including the post‐LVRS examinations, the normalized MAD and MACW significantly correlated with %FEV1 (r = 0.881 and r = 0.906; P < 0.0001, respectively). BMRI seems useful for noninvasively and directly assessing the impaired respiratory mechanics associated with abnormal ventilation in pulmonary emphysema, and also for monitoring the effects of LVRS. J. Magn. Reson. Imaging 1999;10:510–520. © 1999 Wiley‐Liss, Inc.

To evaluate impaired respiratory mechanics in pulmonary emphysema, dynamic breathing magnetic resonance imaging (BMRI) was acquired with fast-gradient echo pulse sequences at fixed thoracic planes over two to three slow, deep respiratory cycles in 6 controls and 28 patients with pulmonary emphysema including 9 patients undergoing lung volume reduction surgery (LVRS). Respiratory motions of the diaphragm and chest wall (D/CW) were assessed by a cineloop view, a fusion display of maximal inspiratory and expiratory images, and the time-distance curves. By contrast with normal subjects with regular synchronous D/CW motions, the patients frequently showed reduced, irregular, or asynchronous motions, with significant decreases in the maximal amplitude of D/CW motions (MAD and MACW), and the length of apposition of the diaphragm (LAD) (P F 0.0001, P F 0.001, P F 0.01, respectively). After LVRS, nine patients showed improvements in D/CW configuration and mobility, with significantly increased MAD, MACW, and LAD (P F 0.01, P F 0.0001, and P F 0.05, respectively). In 40 studies of 28 patients including the post-LVRS examinations, the normalized MAD and MACW significantly correlated with %FEV 1 (r ‫؍‬ 0.881 and r ‫؍‬ 0.906; P F 0.0001, respectively). BMRI seems useful for noninvasively and directly assessing the impaired respiratory mechanics associated with abnormal ventilation in pulmonary emphysema, and also for monitoring the effects of LVRS. J. Magn. Reson. Imaging 1999;10:510-520. 1999 Wiley-Liss, Inc. Index terms: lung; dynamic magnetic resonance (MR) imaging; pulmonary emphysemaAbbreviations: BMRI, breathing magnetic resonance imaging; D/CW, diaphragm and/or chest wall; MAD, maximal amplitude of respiratory motions of the diaphragm; MACW, maximal amplitude of respiratory motions of the chest wall; RM, respiratory muscle; LVRS, lung volume reduction surgery; PFT, pulmonary function test; SPECT, single-photon emission computed tomography; TDC, time-distance curve.