Objectives

Magnetic resonance imaging in pulmonary oncology is limited because of unfavourable physical and physiological conditions in ventilated lung. Previous work showed operability of One Lung Flooding using saline in vivo in MR units, and that valuable conditions for ultrasound and thermal-based interventions exist. Therefore, this study investigates the morphological details of human lung during Lung Flooding to evaluate its further value focusing on MR-guided interventions.

Materials and methods

MR imaging was performed on 20 human lung lobes containing lung cancer and metastases. Lobes were intraoperatively flooded with saline and imaged using T1w Gradient Echo and T2 Spin Echo sequences at 1.5 T. Additionally, six patients received pre-operative MRI.

Results

During lung flooding, all lung tumours and metastases were visualized and clearly demarked from the surrounding lung parenchyma. The tumour mass appeared hyperintense in T1w and hypointense in T2w MR imaging. Intra-pulmonary bronchial structures were well differentiated in T2w and calcification in T1w MR sequences.

Conclusion

Superior conditions with new features of lung MRI were found during lung flooding with an unrestricted visualization of malignant nodules and clear demarcation of intra-pulmonary structures. This could lead to new applications of MR-based pulmonary interventions such as laser or focused ultrasound-based thermal ablations.

中文翻译：

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一次肺水浸润期间肺部肺结节的MR成像：使用离体人肺模型的首次形态评估。

目标

由于通气肺的不利生理和生理状况，肺肿瘤中的磁共振成像受到限制。先前的工作表明，在MR单元中使用盐水在体内进行单肺冲洗的可操作性，并且存在基于超声和热干预的有价值的条件。因此，本研究调查了肺水浸过程中人肺的形态学细节，以评估其在MR指导干预措施方面的进一步价值。

材料和方法

MR成像是在20个含有肺癌和转移灶的人肺叶上进行的。术中用生理盐水冲洗肺叶，并使用T1w梯度回波和T2自旋回波序列在1.5 T下成像。此外，六名患者接受了术前MRI检查。

结果

在肺部充血期间，所有肺部肿瘤和转移灶均可见，并从周围的肺实质中清晰地标出。在T1w中，肿瘤块表现为高强度，在T2w MR成像中，肿瘤为低强度。肺内支气管结构在T2w和T1w MR序列中分化良好。

结论

在肺部充血过程中发现了具有肺部MRI新功能的优越条件，可以无限制地看到恶性结节和清楚地划分肺内结构。这可能会导致基于MR的肺部干预的新应用，例如基于激光或聚焦超声的热消融。