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This study aimed to provide preliminary reference data for lung perfusion and ventilation using PREFUL-MRI in healthy adults, and to characterize the physiological dependencies of these metrics on two breathing patterns, sex, and age.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this prospective observational study, 87 healthy adults underwent PREFUL-MRI at 1.5 T during both normal and deep-slow breathing. Perfusion- and ventilation-related metrics were quantified via an automated pipeline. Paired comparisons between breathing states were performed using Wilcoxon signed-rank tests; unpaired comparisons between sexes and age groups (&lt;\u200945 vs. \u226545 years) used Mann\u2013Whitney U tests, with Holm\u2013Bonferroni and Benjamini\u2013Hochberg false-discovery-rate corrections applied to control for multiple comparisons.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Mean perfusion (7.7% vs. 6.0%, Holm-Bonferroni adjusted\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and ventilation defects (8.6% vs. 5.1%, Holm-Bonferroni adjusted\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.010) were decreased, and mean ventilation (15.8% vs. 48.3%, Holm-Bonferroni adjusted\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and perfusion defects (1.9% vs. 7.9%, Holm-Bonferroni adjusted\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005) increased during deep breathing compared with normal breathing. Twenty-eight participants had increased lung perfusion while 59 had reduced perfusion during deep breathing relative to normal breathing. During normal breathing, men exhibited higher mean ventilation than women (20.2% vs. 14.2%, Holm-Bonferroni adjusted\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.018). During deep breathing, men demonstrated higher total perfusion defect percentage and matched ventilation-perfusion defects than women (FDR adjusted q\u2009&lt;\u20090.05). Total perfusion defect percentage was lower in participants aged\u2009\u2265\u200945 years than in those aged\u2009&lt;\u200945 years (1.8% vs. 2.7%, FDR adjusted q\u2009=\u20090.036). Mean flow-volume loop correlations were similar between breathing patterns, sexes, and age groups after multiple comparison correction (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>PREFUL-MRI can captures physiological variations related to breathing pattern, sex, and age in healthy adults. These findings provide a framework for distinguishing normal physiological heterogeneity from pathological change in clinical PREFUL-MRI interpretation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial number<\/jats:title>\n                    <jats:p>Not applicable.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12880-026-02519-5","type":"journal-article","created":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T18:33:21Z","timestamp":1782153201000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Characteristics of pulmonary perfusion and ventilation in healthy adults: a prospective observational study with phase-resolved functional lung magnetic resonance imaging"],"prefix":"10.1186","volume":"26","author":[{"given":"Anqi","family":"Liu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yifei","family":"Ni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianping","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linfeng","family":"Xi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haoyu","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongyi","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Du","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinzhu","family":"Dai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ke","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanhong","family":"Ren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiyao","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingen","family":"Xia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"An","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Grimm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Voskrebenzev","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens","family":"Vogel-Claussen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,22]]},"reference":[{"issue":"3","key":"2519_CR1","doi-asserted-by":"publisher","first-page":"220272","DOI":"10.1183\/20734735.0272-2022","volume":"19","author":"S Bayat","year":"2023","unstructured":"Bayat S, Wild J, Winkler T. 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