LUNG PERFUSION DEMONSTRATED BY CONTRAST-ENHANCED DYNAMIC MAGNETIC-RESONANCE-IMAGING - APPLICATION TO UNILATERAL LUNG TRANSPLANTATION

RATIONALE AND OBJECTIVES. The authors evaluate the use of magnetic res onance (MR) to image pulmonary perfusion in healthy controls and to de tect pulmonary defects in patients with unilateral lung transplantatio n, using dynamic images after contrast administration. METHODS. Five p atients with right lung transplantation and nine healthy volunteers un derwent MR imaging, Twenty-five subsecond contrast-enhanced MR images (turbo-fast low-angle shot [FLASH]) were obtained at the level of the pulmonary arteries after a single injection of gadopentetate dimeglumi ne (0.1 mmol/kg) in an antecubital vein. Perfusion lung scintigraphy w as done within 24 hours after the MR imaging examination in the transp lanted patients. RESULTS. Before administration of contrast material, MR images showed both lungs to be homogeneous and of low signal intens ity in healthy controls and in patients with lung transplantation. Aft er contrast administration in controls, the mean signal intensity of t he dependent lung increased markedly to 171 +/- 24% above baseline, wh ereas the nondependent signal intensity lung increased by only 105 +/- 17%; these changes were significantly different, In all patients with lung transplantation, a clear perfusion defect was demonstrated in th e native lung, This defect was confirmed in all cases by perfusion nuc lear scintigraphy, which showed that the majority of lung perfusion is directed to the transplanted allograft, compared with the native cont ralateral lung. CONCLUSIONS. Our results suggest that dynamic contrast -enhanced MR imaging is a potential method for detecting pulmonary per fusion defects in patients with lung transplantation.