Robertson HT, Hlastala MP. Microsphere maps of regional blood flow and regional ventilation. J Appl Physiol 102: [1265][1266][1267][1268][1269][1270][1271][1272] 2007. First published December 7, 2006; doi:10.1152/japplphysiol.00756.2006.-Systematically mapped samples cut from lungs previously labeled with intravascular and aerosol microspheres can be used to create high-resolution maps of regional perfusion and regional ventilation. With multiple radioactive or fluorescent microsphere labels available, this methodology can compare regional flow responses to different interventions without partial volume effects or registration errors that complicate interpretation of in vivo imaging measurements. Microsphere blood flow maps examined at different levels of spatial resolution have revealed that regional flow heterogeneity increases progressively down to an acinar level of scale. This pattern of scale-dependent heterogeneity is characteristic of a fractal distribution network, and it suggests that the anatomic configuration of the pulmonary vascular tree is the primary determinant of high-resolution regional flow heterogeneity. At ϳ2-cm 3 resolution, the large-scale gravitational gradients of blood flow per unit weight of alveolar tissue account for Ͻ5% of the overall flow heterogeneity. Furthermore, regional blood flow per gram of alveolar tissue remains relatively constant with different body positions, gravitational stresses, and exercise. Regional alveolar ventilation is accurately represented by the deposition of inhaled 1.0-m fluorescent microsphere aerosols, at least down to the ϳ2-cm 3 level of scale. Analysis of these ventilation maps has revealed the same scale-dependent property of regional alveolar ventilation heterogeneity, with a strong correlation between ventilation and blood flow maintained at all levels of scale. The ventilation-perfusion (V A/Q ) distributions obtained from microsphere flow maps of normal animals agree with simultaneously acquired multiple inert-gas elimination technique V A/Q distributions, but they underestimate gas-exchange impairment in diffuse lung injury.ventilation-perfusion ratio; radioactive microspheres; fluorescent microspheres; aerosol IN VIVO PULMONARY IMAGES OF intravenously injected radionuclide-labeled microspheres and radionuclide-labeled aerosol have been part of the clinical diagnostic armamentarium for over 40 years. The resolution of the old in vivo planar gamma camera images was relatively weak, and lung flow mapping techniques using experimental animals were subsequently developed to gain enhanced spatial resolution. The microsphere mapping approach involves in vivo administration of intravascularly injected and/or aerosol labels, followed by fixation of the lung, systematic cutting and mapping of the cut pieces, and measurement of label concentrations in each piece. The spatial perfusion and/or ventilation maps that are reconstructed from these data have been employed in a wide range of experimental studies. This review will address the advantages and lim...