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Distribution of Ventilation in Lung Transplant Recipients: Evaluation by Dynamic 3He-MRI With Lung Motion Correction

Gast, Klaus Kurt MD*; Puderbach, Michael Ulrich MS*; Rodriguez, Ignacio MSc; Eberle, Balthasar MD; Markstaller, Klaus MD; Knitz, Frank MD; Schmiedeskamp, Joerg MSc§; Weiler, Norbert MD; Schreiber, Wolfgang G. PhD*; Mayer, Eckhardt MD; Thelen, Manfred MD*; Kauczor, Hans-Ulrich MD*

doi: 10.1097/01.rli.0000065422.24911.74
Original Articles

Rationale and objectives. The ability of motion corrected dynamic 3He-magnetic resonance imaging (MRI) to discriminate distributional patterns of inhaled hyperpolarized 3He between different groups of lung transplant recipients was evaluated.

Methods An ultrafast low-angle shot 2D sequence (temporal resolution 128 ms) was used for ventilation 3He-MRI of 11 single and 6 double lung transplant recipients. After digital motion correction, signal kinetics were evaluated in a tracheal and 7 pulmonary regions of interest. Results from grafts and native lungs as well as from normal and rejected grafts were compared with each other and to reference values from healthy subjects.

Results In emphysema patients, median alveolar rise time, a parameter for increase of alveolar signal, was 0.28 seconds for the graft and 0.48 seconds for the native lung, in fibrosis patients its median was 0.46 seconds for the graft and 0.21 seconds for the native lung. In double lung recipients, alveolar rise time was 0.29 seconds in normal and clinically rejected grafts.

Conclusions Dynamic ventilation 3He-MRI discriminated normal lung grafts from diseased native lungs in single lung recipients. Graft rejection in double lung recipients could not be discriminated.

*Department of Radiology, Klinikum Universitaet Mainz, Mainz, Germany; †Unidad de RMN, Universidad Complutense de Madrid, Madrid, Spain; ‡Department of Anesthesiology, Klinikum Universitaet Mainz, Mainz, Germany; §Department of Physics, Universitaet Mainz, Mainz, Germany; and ∥Department of Cardiothoracic and Vascular Surgery, Klinikum Universitaet Mainz, Mainz, Germany.

Received for publication July 17, 2002; accepted November 18, 2002.

Reprints: Klaus Kurt Gast, MD, Department of Radiology, Klinikum Universitaet Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany. E-mail:

© 2003 Lippincott Williams & Wilkins, Inc.