Assessment of ventilation heterogeneity in severe asthma using phase‐resolved functional lung magnetic resonance imaging

PMCID: PMC12177108

PMID: 40534189

DOI: 10.14814/phy2.70423

Journal: Physiological reports

Publication Date: 2025-6-18

Authors: Foo CT, Langton D, Donovan GM, Thompson BR, Noble PB, et al.

Key Points

• PREFUL MRI revealed significantly higher ventilation defect percentages in severe asthma patients (19.9% vs. 1.9% in healthy volunteers)
• Post-bronchodilator improvements were observed in ventilation defect percentage (reduction from 19.9% to 14.7%, p=0.02)
• The technique provides a comprehensive assessment of lung ventilation heterogeneity, potentially offering more nuanced disease monitoring

Summary

This pioneering study investigated ventilation heterogeneity in severe asthma using phase-resolved functional lung magnetic resonance imaging (PREFUL MRI), demonstrating the technique's potential to provide nuanced insights into respiratory mechanics. Among 23 patients with severe asthma and 7 healthy volunteers, researchers found significantly higher ventilation defect percentages and heterogeneity markers in asthma patients compared to healthy controls, with notable improvements observed post-bronchodilator treatment.

The research revealed multiple sensitive biomarkers of ventilation heterogeneity, particularly interquartile distance (IQD) and inhomogeneity index (IHI), which showed marked differences between asthma patients and healthy volunteers. Critically, these markers not only distinguished disease states but also demonstrated responsiveness to bronchodilator intervention, suggesting PREFUL MRI could offer a sophisticated method for assessing lung function beyond traditional spirometry.