From the Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115 (H.H.); Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan (Y.O.); Department of Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pa (W.B.G.); Department of Medical Biophysics, Western University, London, Canada (G.P.); Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (B.M.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea (K.S.L.); Department of Radiology, University of Missouri, Columbia, Mo (T.A.A.); Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.); Department of Radiology, Vancouver General Hospital and University of British Colombia, Vancouver, Canada (J.R.M.); Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.B.S.); Section of Academic Radiology, University of Sheffield, Sheffield, England, United Kingdom (J.M.W.); Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland, United Kingdom (E.J.R.v.B.); Department of Radiology, UW Madison School of Medicine and Public Health, Madison, Wis (M.L.S.); and Diagnostic and Interventional Radiology, University Hospital Heidelberg, Translational Lung Research Center Heidelberg, member of the German Center of Lung Research, Heidelberg, Germany (H.U.K.).
Radiology. 2020 Nov;297(2):286-301. doi: 10.1148/radiol.2020201138. Epub 2020 Sep 1.
Pulmonary MRI provides structural and quantitative functional images of the lungs without ionizing radiation, but it has had limited clinical use due to low signal intensity from the lung parenchyma. The lack of radiation makes pulmonary MRI an ideal modality for pediatric examinations, pregnant women, and patients requiring serial and longitudinal follow-up. Fortunately, recent MRI techniques, including ultrashort echo time and zero echo time, are expanding clinical opportunities for pulmonary MRI. With the use of multicoil parallel acquisitions and acceleration methods, these techniques make pulmonary MRI practical for evaluating lung parenchymal and pulmonary vascular diseases. The purpose of this Fleischner Society position paper is to familiarize radiologists and other interested clinicians with these advances in pulmonary MRI and to stratify the Society recommendations for the clinical use of pulmonary MRI into three categories: suggested for current clinical use, promising but requiring further validation or regulatory approval, and appropriate for research investigations. This position paper also provides recommendations for vendors and infrastructure, identifies methods for hypothesis-driven research, and suggests opportunities for prospective, randomized multicenter trials to investigate and validate lung MRI methods.
肺部 MRI 可提供无电离辐射的肺部结构和定量功能图像，但由于肺实质的信号强度低，其临床应用受到限制。由于没有辐射，肺部 MRI 成为儿科检查、孕妇和需要进行连续和纵向随访的患者的理想检查方式。幸运的是，包括超短回波时间和零回波时间在内的最新 MRI 技术正在扩大肺部 MRI 的临床应用机会。通过使用多线圈并行采集和加速方法，这些技术使得评估肺实质和肺血管疾病的肺部 MRI 变得切实可行。本 Fleischner 学会立场文件的目的是让放射科医生和其他有兴趣的临床医生了解肺部 MRI 的这些进展，并将肺部 MRI 的临床应用建议分为三个类别： 当前临床应用建议、有前景但需要进一步验证或监管批准、适合研究调查。本立场文件还为供应商和基础设施提供了建议，确定了基于假设的研究方法，并为前瞻性、随机多中心试验提供了机会，以研究和验证肺部 MRI 方法。
