ISSN 1305-3825 | E-ISSN 1305-3612
Chest Imaging - Original Article
Pulmonary fibrosis: tissue characterization using late-enhanced MRI compared with unenhanced anatomic high-resolution CT
1 Department of Radiology, St Vincent’s University Hospital, University College Dublin School of Medicine, Dublin, Ireland  
2 Department of Respiratory Medicine, St Vincent’s University Hospital, University College Dublin School of Medicine, Dublin, Ireland  
3 Department of Radiology, St Vincent’s Private Hospital, Dublin, Ireland  
4 Department of Pathology, St Vincent’s University Hospital, University College Dublin School of Medicine, Dublin, Ireland  
5 Department of Radiology, National Jewish Health, Denver, USA  
Diagn Interv Radiol 2017; 23: 106-111
DOI: 10.5152/dir.2016.15331
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Abstract

PURPOSE: We aimed to prospectively evaluate anatomic chest computed tomography (CT) with tissue characterization late gadolinium-enhanced magnetic resonance imaging (MRI) in the evaluation of pulmonary fibrosis (PF).

 

METHODS: Twenty patients with idiopathic pulmonary fibrosis (IPF) and twelve control patients underwent late-enhanced MRI and high-resolution CT. 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 five 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 contrast enhancement on lung late-enhanced MRI. All IPF patients were identified with late-enhanced MRI. Mean signal intensity 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 signal intensity from PF of 204.8%±90.6 compared with the signal intensity of normal lung. The mean contrast-to-noise ratio was 22.8±10.7. Late-enhanced MRI correlated significantly with chest CT for the extent of PF (R=0.78, P = 0.001) but not for reticulation, honeycombing, or coarseness of reticulation or honeycombing.

 

CONCLUSION: Tissue characterization of IPF is possible using inversion recovery sequence thoracic MRI.

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