Magnetic Resonance Imaging in Pulmonary Medicine
Summary
Magnetic resonance imaging (MRI) has emerged as a versatile, radiation-free modality for the combined morphological and functional assessment of the lung. Conventional proton (¹H) MRI suffers from low signal in air-filled tissues and motion artefacts, but advances in hardware, sequence design and image processing have addressed many of these limitations. Ultra-short echo time (UTE) sequences now permit high-resolution depiction of parenchymal structure and nodules, while contrast-enhanced and non-contrast perfusion methods enable regional blood-flow mapping. Hyperpolarised gas MRI, chiefly using ³He or ¹²⁹Xe, provides unique insight into ventilation distribution, microstructure (via diffusion-weighted imaging) and gas-blood exchange at the alveolar–capillary interface. Phase-resolved functional lung (PREFUL) MRI techniques exploit free-breathing acquisitions and retrospective gating to quantify both ventilation and perfusion without exogenous contrast. Together, these approaches facilitate the evaluation of chronic obstructive pulmonary disease, interstitial lung diseases, cystic fibrosis, pulmonary embolism and sequelae of infectious processes such as COVID-19. Functional biomarkers derived from MRI have demonstrated sensitivity to early microvascular changes and gas-transfer impairments, supporting their role in longitudinal monitoring, therapy guidance and prognostication. As protocols continue to mature, MRI is set to complement or, in selected cases, replace computed tomography for comprehensive lung phenotyping in both research and clinical practice.
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Magnetic Resonance Imaging in Pulmonary Medicine publication trend
The graph below shows the total number of articles in magnetic resonance imaging in pulmonary medicine across all publications each year (not limited to Nature Index journals).
Technical terms
Hyperpolarisation: A process that dramatically increases the alignment of nuclear spins above thermal equilibrium to boost MR signal by orders of magnitude.
Apparent diffusion coefficient (ADC): A quantitative measure of gas diffusion within alveolar airspaces, reflecting microstructural dimensions and integrity.
Phase-resolved functional lung (PREFUL)-MRI: A free-breathing MRI technique that retrospectively separates respiratory and cardiac phases to generate regional ventilation and perfusion maps without exogenous contrast.
Ultra-short echo time (UTE): An MRI sequence with minimal echo delay, optimised to capture signal from tissues with very short transverse relaxation times, such as lung parenchyma.
References
- Ultrasensitive 129Xe Magnetic Resonance Imaging: From Clinical Monitoring to Molecular Sensing. Advanced Science (2025).
- Longitudinal Lung Function Assessment of Patients Hospitalized With COVID-19 Using 1H and 129Xe Lung MRI. CHEST Journal (2023).
- Validation of Automated Perfusion‐Weighted Phase‐Resolved Functional Lung (PREFUL)‐MRI in Patients With Pulmonary Diseases. Journal of Magnetic Resonance Imaging (2019).
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