Chest Imaging - Original Article
Pulmonry Fibrosis: tissue characterization imaging using late-enhanced MRI compared to non-contrast anatomic HRCT imaging
Department of Radiology, St Vincent’s University Hospital, Dublin, Ireland
Department of Respiratory Medicine, St Vincent’s University Hospital, Dublin, Ireland
Department of Radiology, St Vincent’s Private Hospital, Dublin, Ireland
Department of Pathology, St Vincent’s University Hospital, Dublin, Ireland
Department of Radiology, National Jewish Health, Denver, CO, USA
Diagn Interv Radiol ; : -
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PURPOSE: To prospectively evaluate anatomic chest CT with tissue characterization late-gadolinium enhanced MRI (LGE-MRI) in the evaluation of pulmonary fibrosis (PF).
METHODS: In this institutional review board approved study all patients gave written informed consent. Twenty patients with idiopathic pulmonary fibrosis (IPF) and twelve control patients underwent LGE-MRI and HRCT. Tissue characterization of PF was depicted using a segmented inversion-recovery turbo low-angle shot MRI sequence. Pulmonary arterial blood pool nulling was achieved by nulling main pulmonary artery signal. Images were read in random order by a blinded reader for presence and extent of overall PF (reticulation and honeycombing) at 5 anatomic levels. Overall extent of IPF was estimated to the nearest 5% as well as an evaluation of the ratios of IPF made up of reticulation and honeycombing. Overall grade of severity was dependent on the extent of reticulation and honeycombing.
RESULTS: No control patient exhibited lung LGE. All IPF patients were identified with LGE-MRI. Mean SI of the late-enhanced fibrotic lung was 31.8±10.6 vs. 10.5±1.6 for normal lung regions, P < 0.001, resulting in a percent elevation in MR SI from PF of 204.8%±90.6 compared with SI of normal lung. The mean contrast-to-noise ratio was 22.8±10.7. LGE-MRI correlated significantly with chest CT for the extent of PF (R=0.78, P=0.001) but not reticulation, honeycombing or coarseness of reticulation or honeycombing (P=NS for all).
CONCLUSION: Tissue characterization of IPF is possible using inversion recovery sequence thoracic MRI.