Activity of diffuse lung diseases: Comparison of high-field Magnetic Resonance Imaging (MRI), Computed Tomography (CT) and clinical evaluation

Purpose: To compare highfield-MRI, CT and clinical data in the assessment of inflammatory activity in patients with diffuse lung disease.

Methods: Prospective evaluation of 23 patients (17 males, 6 females, 24–80 y) with different diffuse lung diseases who underwent clinical work-up inclusive laboratory tests, lung-function tests and transbronchial biopsy. After routine helical CT (additional 10 HRCT), MRI (3.0 Intera, Philips Medical System Best, The Netherlands) using a T2-weighted, cardiac and respiratory triggered Fast-Spinecho-Sequence (TE/TR=80/1500–2500 ms, 22 transverse slices, 7/2mm slice-thickness/-gap) was performed. A pulmonary specialist classified the cases into three groups: A=temporary acute interstitial disease/B=chronic interstitial lung disease with acute episode or superimposed infection/C=burned out interstitial lung disease without activity. Two blinded radiologists graded the cases in active/inactive disease on the basis of 9 morphological criteria each. A third radiologist rated the MRI-cases as active/inactive, depending on the signal-intensities of lung tissues.

Results: The pulmonary specialist judged two patients into group A, 14 patients into group B and seven patients into group C.

• CT-reader-1 classified 4 cases active, 19 inactive.

• CT-reader-2 classified 8 cases active, 15 inactive.

• MRI classified 14 cases as active and nine as inactive disease.

• MRI/reader-1/reader-2 were false positive in 2/1/1 cases, false negative in 4/12/9 cases and correct in 17/10/13 cases.

Conclusion: High-field MRI is superior to CT in the assessment of activity of diffuse lung disease.