Lung MRI as a possible alternative to CT scan for patients with primary immune deficiencies and increased radiosensitivity

Chest. 2011 Dec;140(6):1581-1589. doi: 10.1378/chest.10-3147. Epub 2011 May 26.


Background: Patients with common variable immunodeficiency (CVID) suffer from respiratory infections leading over time to permanent lung damage. Increased radiosensitivity has been described, and clinicians should consider a risk-benefit assessment when ordering a CT scan, in that the exact level of "safe" radiation exposure is unknown.

Methods: Twenty-one patients with CVID were evaluated with chest CT scan, MRI, and pulmonary function tests on the same day. MRI protocol included a T2-weighted rotating blade-like k-space covering sequence (time repetition, 2,000; echo train = 27; field of view, 400 mm; flip angle, 150; slice thickness, 5 mm) on axial and coronal planes. The bronchial and parenchymal abnormalities were compared with those identified by CT scan applying a modified Bhalla scoring system to assess bronchiectasis, bronchial wall thickening, number of bronchial generations involved, mucous plugging, consolidations, emphysema, bullae, and nodules.

Results: CT scan and MRI findings were comparable for moderate to severe degrees of bronchial and parenchymal alterations. A low concordance was found between MRI and CT scan for lower scores of bronchial abnormalities. CT scan allowed a better identification of peripheral airways abnormalities.

Conclusions: Lung alterations in patients with higher radiation sensitivity, such as patients with CVID, might be evaluated by MRI, a radiation-free technique alternative to CT scan.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Bronchiectasis / diagnosis*
  • Bronchiectasis / epidemiology
  • Cohort Studies
  • Common Variable Immunodeficiency / diagnosis*
  • Common Variable Immunodeficiency / epidemiology
  • Comorbidity
  • Female
  • Humans
  • Lung / diagnostic imaging*
  • Lung / pathology*
  • Magnetic Resonance Imaging / methods
  • Male
  • Middle Aged
  • Pulmonary Emphysema / diagnosis*
  • Pulmonary Emphysema / epidemiology
  • Radiation Tolerance / radiation effects*
  • Respiratory Function Tests
  • Retrospective Studies
  • Risk Assessment
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Statistics, Nonparametric
  • Tomography, X-Ray Computed / methods
  • Young Adult