Existing literature describes two distinctive phenotypes of chronic obstructive pulmonary disease (COPD): airway-predominant chronic bronchitis and alveolar-predominant emphysema. In this study, based on results from pulmonary function tests and computed tomography, we found a new mixed phenotype of COPD. This mixed phenotype showed minimal emphysematous tissue destruction, but low diffusion lung capacity (DLCO). Subsequent hyperpolarized xenon-129 MRI results indicated that gas exchange to the pulmonary blood in lungs for this mixed phenotype was significantly impaired as compared to controls and the classic COPD phenotypes.
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