Assessment of Chest High-Field Magnetic Resonance Imaging in Children and Young Adults With Noncystic Fibrosis Chronic Lung Disease: Comparison to High-Resolution Computed Tomography and Correlation With Pulmonary Function

• Published in: Investigative radiology Vol. 44; no. 9; pp. 532 - 538
• Main Authors: Montella, Silvia, Santamaria, Francesca, Salvatore, Marco, Pignata, Claudio, Maglione, Marco, Iacotucci, Paola, Mollica, Carmine
• Format: Journal Article
• Language: English
• Published: United States Lippincott Williams & Wilkins, Inc 01-09-2009
• Subjects: Adolescent; Child; Child, Preschool; Chronic Disease; Cystic Fibrosis - diagnosis; Female; Humans; Image Enhancement - methods; Magnetic Resonance Imaging - methods; Male; Pulmonary Fibrosis - diagnosis; Radiography, Thoracic - methods; Reproducibility of Results; Respiratory Function Tests; Sensitivity and Specificity; Tomography, X-Ray Computed - methods
• ISSN: 0020-9996; 1536-0210
• DOI: 10.1097/RLI.0b013e3181b4c1ba

OBJECTIVES:Magnetic resonance imaging (MRI) has been proposed as a radiation-free alternative to high resolution computed tomography (HRCT) for the assessment and follow-up of chest disorders. Thus far, no study has compared the efficacy of high-field MRI and HRCT in children and adults with noncystic fibrosis (CF) chronic lung disease. The aims of our study were(1) to assess whether chest high-field MRI is as effective as chest HRCT in identifying pulmonary abnormalities; and (2) to investigate the relationships between the severity and extent of lung disease, and functional data in patients with non-CF chronic lung disease.
MATERIALS AND METHODS:Forty-one subjects (median age, 13.8 years; range, 5.9–29.3 years; 30 children/11 adults) with primary ciliary dyskinesia (n = 14), primary immunodeficiency (n = 14), or recurrent pneumonia (n = 13) underwent pulmonary function tests, chest HRCT (120 kV, dose-modulated mAs) and high-field 3.0-T MRI (HASTE; transversal orientation; repetition time/echo time/flip angle/acquisition time, infinite/92 milliseconds/150°/approximately 90 seconds). HRCT and MRI images were scored in consensus by 2 raters using a modified version of the Helbich scoring system. The maximal score was 25.
RESULTS:HRCT and high-field MRI total scores were 11 (range1–20) and 11 (range1–17), respectively. There was good agreement between the 2 techniques for all scores (r > 0.8). HRCT and MRI total scores, and extent of bronchiectasis scores were significantly related to pulmonary function tests (r = −0.4, P < 0.05). The MRI mucous plugging score was significantly related to pulmonary function tests (r = −0.4, P < 0.05).
CONCLUSIONS:Chest high-field 3.0-T MRI appears to be as effective as HRCT in assessing the extent and severity of lung abnormalities in non-CF chronic lung diseases, and might be a reliable radiation-free option to HRCT.