Improved 129Xe MRI of cardiopulmonary oscillations in patients with chronic thromboembolic pulmonary hypertension

Dynamic spectroscopy of hyperpolarized 129Xe in red blood cells exhibits cardiopulmonary oscillations that can be used to detect both pre- and post-capillary pulmonary hypertension (PH). However, this whole-lung measurement cannot resolve spatially heterogeneous variations in oscillations. This limitation can be addressed by using keyhole reconstruction approaches to spatially resolve the oscillations. Here we demonstrate several extensions of this technique that make both the reconstruction and analysis more robust. We have used this to establish updated healthy reference distributions and demonstrate the utility of spatially resolved mapping in a cohort of patients with chronic thromboembolic pulmonary hypertension pre- and post-thromboendarterectomy.