ISSN 1305-3825 | E-ISSN 1305-3612
Chest Imaging - Original Article
Pulmonry Fibrosis: tissue characterization imaging using late-enhanced MRI compared to non-contrast anatomic HRCT imaging
1 Department of Radiology, St Vincent’s University Hospital, Dublin, Ireland  
2 Department of Respiratory Medicine, St Vincent’s University Hospital, Dublin, Ireland  
3 Department of Radiology, St Vincent’s Private Hospital, Dublin, Ireland  
4 Department of Pathology, St Vincent’s University Hospital, Dublin, Ireland  
5 Department of Radiology, National Jewish Health, Denver, CO, USA  
Diagn Interv Radiol ; : -


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.

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