MAGNETIC-RESONANCE-IMAGING OF LUNG SIGNAL INTENSITY AND DIMENSIONS INPATIENTS WITH ADVANCED LUNG-DISEASE BEFORE AND AFTER SINGLE-LUNG TRANSPLANTATION

A retrospective analysis of lung signal intensity normalized for fat a nd lung cross-sectional area normalized for body surface area was obta ined from cardiac gated spin-echo (echo time 40 ms) images before and after single-lung transplantation in 12 patients with pulmonary airway disease (seven emphysema, two bronchiectasis and three obliterative b ronchiolitis) and 14 with interstitial lung disease (three pulmonary f ibro sis, four fibrosing alveolitis and seven lymphangioleiomyomatosis ). Nine healthy volunteers were studied for comparison. The native lun g in pulmonary airway disease without inflammatory processes has norma lised signal intensity (79 +/- 12%) similar to that of the control (10 0 +/- 6%) while interstitial lung disease had a higher normalised sign al intensity (172 +/- 33%; P < 0.05), The transplanted lung had a simi lar normalised signal intensity (103 +/- 12%) to that of the control e xcept when there was a rejection reaction (one patient) or infection ( two patients). Compared with the control, the native lung was smaller in pulmonary fibrosis(50 +/- 8%) and fibrosing alveolitis(78 +/- 8%), while larger in lymphangioleiomyomatosis (136 +/- 6%) and pulmonary ai rway disease (165 +/- 8%). The cross-sectional area of the transplante d lung was comparable to that of the control (100 +/- 13%), Distinctiv e features of lung normalised signal intensity and cross-sectional are a were demonstrated in patients with pulmonary airway disease and inte rstitial lung disease before lung transplantation. These measurements could be useful noninvasive indices for assessment of the transplanted lung and for frequent follow-up of patients without exposure to ioniz ing radiation. Future developments are required to enhance lung signal sufficiently to detect less severe diseases.