MRI of cystic fibrosis lung manifestations: sequence evaluation and clinical outcome analysis

O Scholz; T Denecke; J Böttcher; C Schwarz; H-J Mentzel; F Streitparth; M H Maurer; A Pfeil; A Huppertz; A Mehl; D Staab; B Hamm; D M Renz

doi:10.1016/j.crad.2017.03.017

MRI of cystic fibrosis lung manifestations: sequence evaluation and clinical outcome analysis

Clin Radiol. 2017 Sep;72(9):754-763. doi: 10.1016/j.crad.2017.03.017. Epub 2017 May 22.

Authors

O Scholz¹, T Denecke¹, J Böttcher², C Schwarz³, H-J Mentzel⁴, F Streitparth¹, M H Maurer¹, A Pfeil⁵, A Huppertz¹, A Mehl³, D Staab³, B Hamm¹, D M Renz⁶

Affiliations

¹ Department of Radiology, Charité University Medicine Berlin, Campus Virchow Clinic, Augustenburger Platz 1, 13353 Berlin, Germany.
² Institute of Diagnostic and Interventional Radiology, SRH Clinic Gera, Str. des Friedens 122, 07548 Gera, Germany.
³ Division of Pulmonology and Immunology, Department of Pediatrics, Charité University Medicine Berlin, Campus Virchow Clinic, Augustenburger Platz 1, 13353 Berlin, Germany.
⁴ Institute of Diagnostic and Interventional Radiology, Department of Pediatric Radiology, Friedrich-Schiller-University, Jena University Hospital, Am Klinikum 1, 07740 Jena, Germany.
⁵ Department of Internal Medicine III, Friedrich-Schiller-University, Jena University Hospital, Am Klinikum 1, 07740 Jena, Germany.
⁶ Department of Radiology, Charité University Medicine Berlin, Campus Virchow Clinic, Augustenburger Platz 1, 13353 Berlin, Germany; Institute of Diagnostic and Interventional Radiology, Department of Pediatric Radiology, Friedrich-Schiller-University, Jena University Hospital, Am Klinikum 1, 07740 Jena, Germany. Electronic address: diane.renz@charite.de.

PMID: 28545684
DOI: 10.1016/j.crad.2017.03.017

Abstract

Aim: To evaluate different magnetic resonance imaging (MRI) sequences for diagnosis of pulmonary manifestations of cystic fibrosis (CF) in comparison to chest computed tomography (CT), including an extended outcome analysis.

Materials and methods: Twenty-eight patients with CF (15 male, 13 female, mean age 30.5±9.4 years) underwent CT and MRI of the lung. MRI (1.5 T) included different T2- and T1-weighted sequences: breath-hold HASTE (half Fourier acquisition single shot turbo spin echo) and VIBE (volumetric interpolated breath-hold examination, before and after contrast medium administration) sequences and respiratory-triggered PROPELLER (periodically rotated overlapping parallel lines with enhanced reconstruction) sequences with and without fat signal suppression, and perfusion imaging. CT and MRI images were evaluated by the modified Helbich and the Eichinger scoring systems. The clinical follow-up analysis assessed pulmonary exacerbations within 24 months.

Results: The highest concordance to CT was achieved for the PROPELLER sequences without fat signal suppression (concordance correlation coefficient CCC of the overall modified Helbich score 0.93 and of the overall Eichinger score 0.93). The other sequences had the following concordance: PROPELLER with fat signal suppression (CCCs 0.91 and 0.92), HASTE (CCCs 0.87 and 0.89), VIBE (CCCs 0.84 and 0.85) sequences. In the outcome analysis, the combined MRI analysis of all five sequences and a specific MRI protocol (PROPELLER without fast signal suppression, VIBE sequences, perfusion imaging) reached similar correlations to the number of pulmonary exacerbations as the CT examinations.

Conclusion: An optimum lung MRI protocol in patients with CF consists of PROPELLER sequences without fat signal suppression, VIBE sequences, and lung perfusion analysis to enable high diagnostic efficacy and outcome prediction.

Publication types

Clinical Trial
Comparative Study

MeSH terms

Adult
Contrast Media
Cystic Fibrosis / diagnostic imaging*
Female
Humans
Image Enhancement / methods*
Image Interpretation, Computer-Assisted / methods
Magnetic Resonance Imaging / methods*
Male
Middle Aged
Prospective Studies
Tomography, X-Ray Computed / methods*

Substances

Contrast Media