Radiol Cardiothorac Imaging. 2026 Jun;8(3):e250334. doi: 10.1148/ryct.250334.
ABSTRACT
Purpose To investigate the association between impaired lung function and pulmonary perfusion defect percentage (QDP) using phase-resolved functional lung (PREFUL) MRI. Materials and Methods In this prospective study (March 2023-July 2024), participants underwent spirometry to assess lung function, including forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC). Lung function was classified as either normal or impaired, with the impaired category including airflow obstruction (AO), restrictive physiology (RP), and preserved ratio impaired spirometry (PRISm). Additionally, all participants underwent PREFUL MRI for ventilation and perfusion assessment and CT for emphysema evaluation. Linear regression models were used to evaluate associations between QDP and pulmonary function status, and restricted cubic spline (RCS) analysis was applied to explore potential nonlinear relationships. Results A total of 287 participants were included (mean age ± SD, 60 years ± 13; 228 males). Compared with normal spirometry, PRISm (β = 3.20; 95% CI: 1.40, 5.01; P = .002), RP (β = 3.88; 95% CI: 1.63, 6.12; P = .002), and AO (β = 8.49; 95% CI: 6.59, 10.39; P < .001) were significantly associated with QDP. Lower FEV1% predicted, FVC% predicted, and FEV1/FVC ratio, as well as increased emphysema percentage, were associated with higher QDP. RCS analysis revealed nonlinear associations between pulmonary function indicators and QDP. Subgroup analysis demonstrated significant interactions between lung function impairment and factors such as body mass index and age. Conclusion Impaired lung function was associated with increased pulmonary perfusion defects as detected by PREFUL MRI. Keywords: Thorax, MR-Functional Imaging, Preserved Ratio Impaired Spirometry, Phase-resolved Functional Lung, Perfusion Defects, Ventilation Defects, Lung Emphysema Chinese Clinical Trial Registry: ChiCTR2300077789 and ChiCTR2300074883 Supplemental material is available for this article. © RSNA, 2026.
PMID:42240461 | DOI:10.1148/ryct.250334