We assessed the sensitivity of a comprehensive multi-nuclear lung function-structure imaging protocol to acute changes in the lungs of patients admitted to hospital with COVID-19 lung infection. Dissolved 129Xe spectroscopic imaging and DCE 1H perfusion MRI indicate impaired gas transfer related to diffusion and microvascular perfusion limitation, whilst 129Xe ventilation MRI and 129Xe DWI indicate fairly homogenous lung ventilation and airway microstructure, apart from in areas showing clear structural abnormality on UTE/ZTE imaging (residual ground glass opacity or consolidation). The findings provide quantitative regional insight in to why patients suffer from severe breathlessness despite their lung ventilation appearing near normal.
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