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Lung morphology assessment of cystic fibrosis using MRI with ultra-short echo time at submillimeter spatial resolution

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Abstract

Objectives

We hypothesized that non-contrast-enhanced PETRA (pointwise encoding time reduction with radial acquisition) MR (magnetic resonance) sequencing could be an alternative to unenhanced computed tomography (CT) in assessing cystic fibrosis (CF) lung structural alterations, as well as compared agreements and concordances with those of conventional T1-weighted and T2-weighted sequences.

Material and methods

Thirty consecutive CF patients completed both CT and MRI the same day. No contrast injection was used. Agreement in identifying structural alterations was evaluated at the segmental level using a kappa test. Intraclass correlation coefficients (ICC) and Bland-Altman analysis were used to assess concordances and reproducibility in Helbich-Bhalla disease severity scoring.

Results

Agreement between PETRA and CT was higher than that of T1- or T2-weighted sequences, notably in assessing the segmental presence of bronchiectasis (Kappa = 0.83; 0.51; 0.49, respectively). The concordance in Helbich-Bhalla scores was very good using PETRA (ICC = 0.97), independently from its magnitude (mean difference (MD) = -0.3 [-2.8; 2.2]), whereas scoring was underestimated using both conventional T1 and T2 sequences (MD = -3.6 [-7.4; 0.1]) and MD = -4.6 [-8.2; -1.0], respectively). Intra- and interobserver reproducibility were very good for all imaging modalities (ICC = 0.86-0.98).

Conclusion

PETRA showed higher agreement in describing CF lung morphological changes than that of conventional sequences, whereas the Helbich-Bhalla scoring matched closely with that of CT.

Key Points

• Spatial resolution of lung MRI is limited using non-ultra-short TE MRI technique

• Ultra-short echo time (UTE) technique enables submillimeter 3D-MRI of airways

• 3D-UTE MRI shows very good concordance with CT in assessing cystic fibrosis

• Radiation-free 3D-UTE MRI enables the Helbich-Bhalla scoring without a need for contrast injection

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Abbreviations

CT:

Computed tomography

MRI:

Magnetic resonance imaging

3D:

Three-dimensional

2D:

Two-dimensional

UTE:

Ultra-short echo time

GRE:

Gradient echo

PETRA:

Pointwise encoding time reduction with radial acquisition

CF:

Cystic fibrosis

ICC:

Intraclass correlation coefficient

MD:

Mean deviation (N mm)3 = N × N × N mm3

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Acknowledgments

The scientific guarantor of this publication is François Laurent. The authors thank Mr. David Grodzki from Siemens Healthcare Company for technical support. This study has received funding by the Laboratory of Excellence TRAIL, ANR-10-LABX-57. One of the authors (Professor Patrick Berger) has significant statistical expertise. Institutional Review Board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Methodology: prospective, observational, performed at one institution.

Author information

Authors and Affiliations

  1. University of Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, F-33000, Bordeaux, France

    Gaël Dournes, Julie Macey, Michaël Fayon, Marjorie Salel, Olivier Corneloup, Michel Montaudon, Patrick Berger & François Laurent

  2. INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, F-33000, Bordeaux, France

    Gaël Dournes, Julie Macey, Michaël Fayon, Michel Montaudon, Patrick Berger & François Laurent

  3. CHU de Bordeaux, Service d’Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service d’Exploration Fonctionnelle Respiratoire, CIC 1401, F-33600, Pessac, France

    Gaël Dournes, Julie Macey, Marjorie Salel, Olivier Corneloup, Michel Montaudon, Patrick Berger & François Laurent

  4. CHU de Bordeaux, Service d’Imagerie de la Femme et de l’Enfant, Unité de Pneumologie pédiatrique, F-33000, Bordeaux, France

    Fanny Menut, Michaël Fayon & Jean-François Chateil

  5. University of Bordeaux, Centre de Résonance Magnétique des Systèmes Biologiques, UMR 5536, 33076, Bordeaux, France

    Jean-François Chateil

  6. Centre de Recherche Cardio-thoracique de Bordeaux, INSERM, U1045, Université de Bordeaux, 146 rue Léo Saignat, 33076, Bordeaux, Cedex, France

    Gaël Dournes

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  1. Gaël Dournes
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  2. Fanny Menut
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  3. Julie Macey
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Corresponding author

Correspondence to Gaël Dournes.

Electronic supplementary material

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Supplemental Table 1

Criteria of cystic fibrosis severity according to the Helbich Scoring System (XLSX 14 kb)

Supplemental Table 2

Artifact assessment using CT and MRI (XLSX 14 kb)

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Dournes, G., Menut, F., Macey, J. et al. Lung morphology assessment of cystic fibrosis using MRI with ultra-short echo time at submillimeter spatial resolution. Eur Radiol 26, 3811–3820 (2016). https://doi.org/10.1007/s00330-016-4218-5

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  • DOI: https://doi.org/10.1007/s00330-016-4218-5

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