Lavelle Lisa P, Brady Darragh, McEvoy Sinead, Murphy David, Gibney Brian, Gallagher Annika, Butler Marcus, Shortt Fionnula, McMullen Marie, Fabre Aurelie, Lynch David A, Keane Michael P, Dodd Jonathan D
Department of Radiology, St Vincent's University Hospital, University College Dublin School of Medicine, Dublin, Ireland.
Diagn Interv Radiol. 2017 Mar-Apr;23(2):106-111. doi: 10.5152/dir.2016.15331.
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).
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.
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.
Tissue characterization of IPF is possible using inversion recovery sequence thoracic MRI.
我们旨在前瞻性地评估胸部解剖计算机断层扫描（CT）联合组织特征延迟钆增强磁共振成像（MRI）在评估肺纤维化（PF）中的作用。
20例特发性肺纤维化（IPF）患者和12例对照患者接受了延迟增强MRI和高分辨率CT检查。使用分段反转恢复快速低角度激发MRI序列描绘PF的组织特征。通过消除主肺动脉信号实现肺动脉血池信号抑制。由一名不知情的阅片者以随机顺序读取图像，观察五个解剖层面上总体PF（网状影和蜂窝状影）的存在情况和范围。IPF的总体范围估计精确到最接近的5%，并评估由网状影和蜂窝状影构成的IPF比例。严重程度的总体分级取决于网状影和蜂窝状影的范围。
对照患者在肺部延迟增强MRI上均未表现出对比增强。所有IPF患者均通过延迟增强MRI得以识别。延迟增强的纤维化肺组织的平均信号强度为31.8±10.6，而正常肺区域为10.5±1.6，P<0.001，与正常肺信号强度相比，PF的信号强度升高百分比为204.8%±90.6。平均对比噪声比为22.8±10.7。延迟增强MRI与胸部CT在PF范围方面显著相关（R=0.78，P = 0.001），但在网状影、蜂窝状影或网状影及蜂窝状影的粗糙程度方面不相关。
使用反转恢复序列胸部MRI可以对IPF进行组织特征描绘。
