Visualization of inert gas wash-out during high-frequency oscillatory ventilation using fluorine-19 MRI.

High-frequency oscillatory ventilation is looked upon as a lung-protective ventilation strategy. For a further clarification of the physical processes promoting gas transport, a visualization of gas flow and the distribution of ventilation are of considerable interest. Therefore, fluorine-19 magnetic resonance imaging of the imaging gas octafluorocyclobutane (C(4) F(8) ) during high-frequency oscillatory ventilation was performed in five healthy pigs. For that, a mutually compatible ventilation-imaging system was set up and transverse images were acquired every 5 sec using FLASH sequences on a 1.5 T scanner. Despite a drop in signal-to-noise ratio after the onset of high-frequency oscillatory ventilation, for each pig, the four experiments could be analyzed. A mean wash-out time (τ) at 5 Hz of 52.7 ± 18 sec and 125.9 ± 39 sec at 10 Hz, respectively, were found for regions of interest including the whole lung. This is in agreement with the clinical findings, in that wash-out of respiratory gases is significantly prolonged for increased high-frequency oscillatory ventilation frequencies. Our study could be a good starting-point for a further optimization of high-frequency oscillatory ventilation.