Abstract
Objectives
To evaluate the diagnostic performance of five MR sequences to detect pulmonary infectious lesions in patients with invasive fungal infection (IFI), using multidetector computed tomography (MDCT) as the reference standard.
Methods
Thirty-four immunocompromised patients with suspected IFI underwent MDCT and MRI. The MR studies were performed using five pulse sequences at 3.0 T: T2-weighted turbo spin echo (TSE), short-tau inversion recovery (STIR), spectrally selective attenuated inversion recovery (SPAIR), T1-weighted high resolution isotropic volume excitation (e-THRIVE) and T1-weighted fast field echo (T1-FFE). The size, lesion-to-lung contrast ratio and the detectability of pulmonary lesions on MR images were assessed. Image quality and artefacts on different sequences were also rated.
Results
A total of 84 lesions including nodules (n = 44) and consolidation (n = 40) were present in 75 lobes. SPAIR and e-THRIVE images achieved high overall lesion-related sensitivities for the detection of pulmonary abnormalities (90.5 % and 86.9 %, respectively). STIR showed the highest lesion-to-lung contrast ratio for nodules (21.8) and consolidation (17.0), whereas TSE had the fewest physiological artefacts.
Conclusions
MRI at 3.0 T can depict clinically significant pulmonary IFI abnormalities with high accuracy compared to MDCT. SPAIR and e-THRIVE are preferred sequences for the detection of infectious lesions of 5 mm and larger.
Key Points
• A radiation-free radiological method is desirable for assessing pulmonary infectious lesions
• MRI at 3 T can depict lung infiltrates with good concordance to MDCT
• SPAIR and e-THRIVE are favourable sequences for the detection of pulmonary lesions
• The greatest benefit is for the diagnosis of lesions larger than 5 mm
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Abbreviations
- 2D:
-
Two-dimensional
- 3D:
-
Three-dimensional
- e-THRIVE:
-
T1-weighted high resolution isotropic volume excitation
- HU:
-
Hounsfield unit
- IFI:
-
Invasive fungal infection
- MDCT:
-
Multidetector computed tomography
- RT:
-
Respiratory triggered
- SPAIR:
-
Spectrally selective attenuated inversion recovery
- STIR:
-
Short-tau inversion recovery
- T1-FFE:
-
T1-weighted fast field echo
- TSE:
-
Turbo spin echo
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Acknowledgements
The scientific guarantor of this publication is Prof. Yikai Xu. The authors of this manuscript declare relationships with the following companies: Philips Electronics Ltd. One co-author (Queenie Chan) is an employee of Philips Electronics Hong Kong Ltd. Dr. Chan contributed to designing the study, the establishment of the radiology project, and editing and revising the manuscript. The authors state that this work has not received any funding. Prof. Xuhui Tan kindly provided statistical advice for this manuscript. Institutional review board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. None of the study subjects or cohorts have been previously reported. Methodology: prospective, diagnostic study, performed at one institution.
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Yan, C., Tan, X., Wei, Q. et al. Lung MRI of invasive fungal infection at 3 Tesla: evaluation of five different pulse sequences and comparison with multidetector computed tomography (MDCT). Eur Radiol 25, 550–557 (2015). https://doi.org/10.1007/s00330-014-3432-2
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DOI: https://doi.org/10.1007/s00330-014-3432-2