Abstract
The low proton density and high signal decay rate of pulmonary tissue have previously hampered the application of magnetic resonance imaging (MRI) in the clinical evaluation of lung disorders. With the continuing technical advances in scanners, coils, pulse sequences, and image postprocessing, pulmonary MRI can provide structural and functional information with faster imaging speed and improved image quality, which has shown potential to be an alternative and complementary diagnostic method to chest computed tomography (CT). Compared with CT, MRI does not involve ionizing radiation, making it particularly suitable for pediatric patients, pregnant women, and individuals requiring longitudinal monitoring. This narrative review focuses on recent advances in techniques and clinical applications for pulmonary MRI in lung diseases, including lung parenchymal and pulmonary vascular diseases. Future developments, including artificial intelligence-driven technological optimization and assisted diagnosis, hardware advancements, and clinical biomarkers validation, hold the potential to further enhance the clinical utility of pulmonary MRI. EVIDENCE LEVEL: 5 TECHNICAL EFFICACY: Stage 2.